Healthcare Provider Details

I. General information

NPI: 1851360010
Provider Name (Legal Business Name): JOEL T GRANT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 07/19/2022
Certification Date: 07/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 WARRIOR DR
STEPHENS CITY VA
22655-4044
US

IV. Provider business mailing address

160 WARRIOR DR
STEPHENS CITY VA
22655-4044
US

V. Phone/Fax

Practice location:
  • Phone: 540-868-4100
  • Fax: 540-868-0888
Mailing address:
  • Phone: 540-868-4100
  • Fax: 540-868-0888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101233394
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: