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Individual

DR. GRANT PEGRAM SIMMONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
400 BERYWOOD TRL NW STE B, CLEVELAND, TN 37312-5288
(423) 472-3201
(423) 476-4949
Mailing address
400 BERYWOOD TRL NW STE B, CLEVELAND, TN 37312-5288
(423) 472-3201
(423) 476-4949

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD0000045559
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00016605
MS
05
1148245
LA
Enumeration date
01/04/2007
Last updated
06/24/2014
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