Individual
GARIC GRISBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
900 WILKINSON ST, MANDEVILLE, LA 70448-3533
(985) 624-4450
(985) 624-4461
Mailing address
4512 ORLEANS BLVD, JEFFERSON, LA 70121-1224
(504) 905-8970
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
23982
MS
2084P0800X
Psychiatry Physician
Primary
307905
LA
Other
Enumeration date
05/16/2014
Last updated
04/24/2025
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