JACK W GRINNAN (NPI# 1487090288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1487090288 |
Entity Type | Individual |
Full Name | JACK W GRINNAN |
Credential | M.D. |
Practice Address |
19841 N 27th Ave Ste 201 Phoenix AZ 85027-4005 |
Mailing Address |
77 E Thomas Rd Ste 230 Phoenix AZ 85012-3100 |
Practice Telephone | 6235826420 |
Practice Fax Number | 6235826720 |
Mailing Telephone | 6025570007 |
Mailing Fax Number | 6025570002 |
Enumeration Date | 2013-05-20 |
Last Update Date | 2018-08-17 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208800000X | Urology | 55776 | AZ | Allopathic & Osteopathic Physicians |
N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | 372496 | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
263 Farmington Ave, Farmington, CT 060321956 | 8606792147 |
Street Address |
19841 N 27TH AVE STE 201 |
City | PHOENIX |
State | AZ |
Zip Code | 85027-4005 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891306312 | Ashley Nicole Felipe | Registered Nurse | 25700 N 21st Ave, Phoenix, AZ 85027 | 2020-08-10 |
1942784376 | Crystal Rodriguez | Dentist | 2550 W Union Hills Dr Ste 201, Phoenix, AZ 85027 | 2018-09-21 |
1790284776 | Lydia Kuuipo Chong | Nurse Practitioner | 20414 N 27th Ave #300, Phoenix, AZ 85027 | 2018-02-06 |
1457867004 | Kristi Marie Mathews | Nurse Practitioner | 19829 N 29th Avenue, Phoenix, AZ 85027 | 2017-12-19 |
1710348362 | The Empower House, LLC | Community Based Residential Treatment Facility, Mental Illness | 18631 N. 19th Ave., Suite 158-305, Phoenix, AZ 85027 | 2016-03-10 |
1972979656 | Dr Daniel H Yohannes D.d.s., PC | Dentist | 602 W. Union Hills Dr, #8, Phoenix, AZ 85027 | 2015-08-17 |
1013346857 | Dentistry At 35th Avenu | Dentist | 18635 N 35th Avenue, Phoenix, AZ 85027 | 2013-11-02 |
1437592102 | Ammar Alobaidy | Psychiatry & Neurology | 21410 N 19th Ave Ste 151, Phoenix, AZ 85027 | 2013-04-12 |
1588900021 | Jill Elizabeth Maroscia | Social Worker | 19636 N 27th Ave #106, Phoenix, AZ 85027 | 2013-01-02 |
1124394515 | Sfjg Holdings LLC | Dentist | 3414 W. Union Hills Dr, Suite 12 & 14, Phoenix, AZ 85027 | 2012-03-29 |
Find all providers in zip 85027 |
Taxonomy Code | 208800000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Urology |
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558879759 | Alliance Oncology of Arizona, LLC | Urology | 2525 E Arizona Biltmore Cir Ste C236, Phoenix, AZ 85016-2130 | 2018-01-22 |
1912327198 | Kris Miguel Cajipe | Urology | 15920 S 48th St Ste 100, Phoenix, AZ 85048-1003 | 2014-04-25 |
1841610003 | Elizabeth Ashley Tourville | Urology | 1313 E Osborn Rd Ste B-150, Phoenix, AZ 85014-5678 | 2014-04-25 |
1932378700 | Kevin R Bigelow | Urology | 15920 S. 48th Street, Suite 100, Phoenix, AZ 85048-1003 | 2008-02-26 |
1922205186 | Daniel Young Woodruff | Urology | 2444 W. Las Palmaritas Dr, Mail Stop A 112, Phoenix, AZ 85021 | 2007-06-29 |
1265588859 | Lauren Byrne | Urology | 15920 S 48th St, Suite 100, Phoenix, AZ 85048-1003 | 2007-01-26 |
1376576348 | Prostate Solutions of Arizona, P.C. | Urology | 1 E Camelback Rd, Suite 700, Phoenix, AZ 85012-1668 | 2006-07-10 |
1336181205 | Ilya A Volfson | Urology | 4530 E Ray Rd Ste 128, Phoenix, AZ 85044-6096 | 2006-06-12 |
1750320842 | Yoon Mark Hong | Urology | 2222 E Highland Ave Ste 206, Phoenix, AZ 85016 | 2006-06-05 |
1689648685 | Adrian H Feng | Urology | 1313 E Osborn Rd, Suite B150, Phoenix, AZ 85014-5678 | 2006-02-15 |
Find all providers in PHOENIX |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.