MEDICARE: DR. JAMES LEE GRIGSBY 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	207RC0000X	Cardiovascular Disease Physician	ME92832	FL
2	207RC0000X	Cardiovascular Disease Physician	51147	CO

Other Identifiers

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

General Provider Information

NPI Number	:	1689677718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES LEE GRIGSBY MD

Provider Business Mailing Address
First Line	:	106 BLANCA AVE
Second Line	:
City	:	ALAMOSA
State	:	CO
Zip	:	81101-2340
Country	:	US
Telephone Number	:	719-587-1417
Fax Number	:	719-587-6324

Provider Business Practice Location Address
First Line	:	106 BLANCA AVE
Second Line	:
City	:	ALAMOSA
State	:	CO
Zip	:	81101-2340
Country	:	US
Telephone Number	:	719-587-1298
Fax Number	:	719-587-1372

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	05/04/2021

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