Healthcare Provider Details

I. General information

NPI: 1922136449
Provider Name (Legal Business Name): WINSTON HENRY GRINER SR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 06/02/2020
Certification Date: 06/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5722 HICKORY PLZ STE B4
NASHVILLE TN
37211-8573
US

IV. Provider business mailing address

5722 HICKORY PLZ STE B4
NASHVILLE TN
37211-8573
US

V. Phone/Fax

Practice location:
  • Phone: 615-429-6420
  • Fax: 615-730-5036
Mailing address:
  • Phone: 615-429-6420
  • Fax: 615-730-5036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberMD0000012084
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: