MEDICARE: JAMES A GRANTHAM MD

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
1	207RI0011X	Interventional Cardiology Physician	2000158901	MO

General Provider Information

NPI Number	:	1134185390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES A GRANTHAM MD

Provider Business Mailing Address
First Line	:	901 E 104TH ST
Second Line	:	MAILSTOP 400S
City	:	KANSAS CITY
State	:	MO
Zip	:	64131
Country	:	US
Telephone Number	:	816-502-7117
Fax Number	:	816-932-9670

Provider Business Practice Location Address
First Line	:	4330 WORNALL RD
Second Line	:	SUITE 2000
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-5939
Country	:	US
Telephone Number	:	816-931-1883
Fax Number	:	816-756-3645

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	09/21/2020

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