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Physician Compare National (NPI:1487909859)

HEALTHCARE PROVIDER: JA'LARNA J GRANT MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1487909859
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 8921396326
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20161018002833
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name GRANT
Individual professional last name
Provider First Name JA'LARNA
Individual professional first name
Provider Middle Name J
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Individual professional's medical school
Graduation Year 2012
Individual professional's medical school graduation year
Primary Specialty OBSTETRICS/GYNECOLOGY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name PRIMARY CARE GROUP, LLC
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 0941480131
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 103
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 4250 BETHEL RD
Group Practice or individual's line 1 address
Line 2 Street Address FL 5
Group Practice or individual's line 2 address
City OLIVE BRANCH
Group Practice or individual's city
State MS
Group Practice or individual's state
Zip Code 386548737
Group Practice or individual's zip code (9 digits when available)
Phone Number 6629329544
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Hospital Affiliation CCN 1 250167
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 METHODIST HEALTHCARE - OLIVE BRANCH HOSPITAL
Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment Y

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