Jerry H Grant, M.D., P.A.
Clinic/Center in El Dorado, AR. Organization (NPI-2).
Details
- NPI
- 1366745705
- Entity type
- Organization (NPI-2)
- Legal business name
- Jerry H Grant, M.D., P.A.
- Organization subpart
- No
- Enumeration date
- Dec 7, 2010
- Last updated
- Aug 7, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | E-0952 | AR | Yes |
Other names
- Grantmed (Doing Business As)
Practice location
104 E Grove StEl Dorado, AR 71730
Phone 870-862-2285 · Fax 870-862-2289
Mailing address
104 E Grove StEl Dorado, AR 71730-4607
Phone 870-862-2285 · Fax 870-862-2289
Other practice locations
El Dorado, AR 71730
Phone 870-862-2285 · Fax 870-862-2289
Authorized official
Jerry Henry Grant
Owner/Physician
8708622285
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All 5 Clinic/Center providers in El Dorado · All 757 providers in El Dorado
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