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NPI Code Detail

MEDICARE: JORDAN DAVID GRIMES

MEDICARE: JORDAN DAVID GRIMES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175T00000XPeer SpecialistOH

General Provider Information

NPI Number : 1679405708
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN DAVID GRIMES
Provider Business Mailing Address
First Line : 1601 S MAIN ST
Second Line :
City : AKRON
State : OH
Zip : 44301-1664
Country : US
Telephone Number : 234-260-2714
Fax Number :
Provider Business Practice Location Address
First Line : 1601 S MAIN ST
Second Line :
City : AKRON
State : OH
Zip : 44301-1664
Country : US
Telephone Number : 234-260-2714
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2026
Last Update Date : 06/05/2026

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Directions to “ JORDAN DAVID GRIMES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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