Grant, Jerry H
Grant, Jerry H is an sole proprietor health care provider with primary practice located at 104 East Grove Grantmed, El Dorado AR 71730-3929. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Grant, Jerry H can be contacted via phone (870) 862-2285.Contact Information
Primary practice address
104 East Grove Grantmed
El Dorado AR 71730-3929
Phone: (870) 862-2285
Fax: (870) 862-2289
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | EO952 | Arkansas |
Profile Details
| NPI number | 1396714424 |
|---|---|
| LBN Legal business name | Grant, Jerry H |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 14th, 2006 |
| Last updated | Aug 21st, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396714424 | NPPES |
| Arkansas | Other | 080128979 | RAILROAD MEDICARE |
| Arkansas | MEDICAID | 130237001 | RAILROAD MEDICARE |
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