Grant, Jonathan Douglas

Grant, Jonathan Douglas is an individual health care provider with primary practice located at 5121 S Cottonwood St , Murray UT 84107-5701. He recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as his primary health care specialty. Grant, Jonathan Douglas can be contacted via phone (801) 507-3888.

Contact Information

Primary practice address
5121 S Cottonwood St Murray UT 84107-5701
Fax: (801) 442-3263
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X AU3354177 Texas
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X 2015-00676 North Carolina
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X 38030 South Carolina
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X 10124565-1205 Utah

Profile Details

NPI number 1861738189
LBN Legal business name Grant, Jonathan Douglas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2012
Last updated Jan 12th, 2017 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861738189 NPPES
South Carolina MEDICAID GA1773
South Carolina MEDICAID 1861738189

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