Organization
ROBERT CLYDE GRANT MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT CLYDE GRANT MD (OWNER)
(770) 536-1381
Entity
Organization
Contact information
Practice address
174 PRIOR ST SE, GAINESVILLE, GA 30501-3447
(770) 536-1381
(770) 532-8721
Mailing address
174 PRIOR ST SE, GAINESVILLE, GA 30501-3447
(770) 536-1381
(770) 532-8721
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
8102
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000070815A
—
GA
Enumeration date
02/24/2010
Last updated
02/24/2010
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