Individual
DR. JENNIFER L GRISHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1573 MEDICAL PARK CIR, TUPELO, MS 38801-6580
(662) 844-9885
(662) 842-1350
Mailing address
1573 MEDICAL PARK CIR, TUPELO, MS 38801-6580
(662) 844-9885
(662) 842-1350
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
19348
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06085766
—
MS
Enumeration date
09/14/2006
Last updated
01/20/2011
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