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NPI Code Detail

MEDICARE: MR. JAMES ROBERT GRIGSBY O.D.

MEDICARE:  MR. JAMES ROBERT GRIGSBY  O.D.
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
1152W00000XOptometrist1417NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215934641
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAMES ROBERT GRIGSBY O.D.
Provider Business Mailing Address
First Line : 307 OAK MEADOW LN
Second Line :
City : MOCKSVILLE
State : NC
Zip : 27028-5505
Country : US
Telephone Number : 336-878-0754
Fax Number :
Provider Business Practice Location Address
First Line : 2120 STATESVILLE BLVD
Second Line :
City : SALISBURY
State : NC
Zip : 28147-1410
Country : US
Telephone Number : 704-636-0559
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 08/13/2008

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Directions to “ MR. JAMES ROBERT GRIGSBY O.D.” Practice Location

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