Individual
KENNETH A GRINSPUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
105 S WILLOW AVE, COOKEVILLE, TN 38501-4667
(931) 526-9518
(931) 372-0087
Mailing address
105 S WILLOW AVE, COOKEVILLE, TN 38501-4667
(931) 526-9518
(931) 372-0087
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
16020
MS
207X00000X
Orthopaedic Surgery Physician
55872
KY
207X00000X
Orthopaedic Surgery Physician
Primary
MD42863
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00760204
MEDICARE RR
—
05
—
1514485
—
TN
01
—
4228439
BCBS OF TN
TN
01
—
7835385
AETNA
—
Enumeration date
07/12/2005
Last updated
12/08/2021
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