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NPI Code Detail

MEDICARE: DR. ROGER T GRIMES D.O.

MEDICARE:  DR. ROGER T GRIMES  D.O.
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
1207X00000XOrthopaedic Surgery Physician1178AZ

General Provider Information

NPI Number : 1598737306
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROGER T GRIMES D.O.
Provider Business Mailing Address
First Line : PO BOX 27340
Second Line :
City : PHOENIX
State : AZ
Zip : 85061-7340
Country : US
Telephone Number : 602-943-9200
Fax Number : 602-216-3000
Provider Business Practice Location Address
First Line : 3002 N COUNTRY CLUB RD
Second Line :
City : TUCSON
State : AZ
Zip : 85716-1603
Country : US
Telephone Number : 520-795-0610
Fax Number : 520-325-4012
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2006
Last Update Date : 12/06/2007

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Directions to “ DR. ROGER T GRIMES D.O.” Practice Location

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