Herbert Galen Grantham, M.D.
Pathology, Anatomic Pathology & Clinical Pathology in Fort Scott, KS. Individual provider (NPI-1).
NPI number1790883643
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1790883643
- Entity type
- Individual (NPI-1)
- Name
- Herbert Galen Grantham
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 21, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207ZP0102X | Pathology, Anatomic Pathology & Clinical Pathology | 04-20707 | KS | Yes |
| 207ZP0102X | Pathology, Anatomic Pathology & Clinical Pathology | MDR6E98 | MO |
Practice location
701 W 8th StFort Scott, KS 66701-2403
Phone 620-223-5032 · Fax 620-223-5071
Mailing address
701 W 8th StFort Scott, KS 66701-2403
Phone 620-223-5032 · Fax 620-223-5071
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