Healthcare Provider Details

I. General information

NPI: 1659953065
Provider Name (Legal Business Name): MATTHEW J GROYSMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2021
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2680 S AVENUE B
YUMA AZ
85364-6901
US

IV. Provider business mailing address

2400 S AVENUE A
YUMA AZ
85364-7127
US

V. Phone/Fax

Practice location:
  • Phone: 928-336-1476
  • Fax: 928-336-9622
Mailing address:
  • Phone: 928-344-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number81047
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: