Individual
DR. GARRY D GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2055 MUD CREEK RD, EUREKA, MT 59917-9070
(812) 424-2020
(812) 424-3000
Mailing address
PO BOX 2450, EUREKA, MT 59917-2450
(812) 204-1703
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
MED-PHYS-LIC-57501
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000042320
ANTHEM
—
05
—
200000980
—
IN
01
—
259157
HEALTHLINK
—
01
—
4500741
AETNA
—
05
—
64878010
—
KY
Enumeration date
09/19/2005
Last updated
11/18/2022
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