Gary L Grogan (NPI# 1508264995, PAC ID# 6406133297) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CLINICAL PSYCHOLOGIST.
| Nation Provider ID (NPI) | 1508264995 |
| PAC ID by PECOS | 6406133297 |
| Professional Enrollment ID | I20170504000267 |
| Full Name | Gary L Grogan |
| Organization Legal Name | NEZ PERCE TRIBAL HEALTH AUTHORITY |
| Address |
111 Bever Grade Rd Lapwai ID 83540 |
| Phone Number | 2088432271 |
| Gender | M |
| Graduation Year | 2015 |
| Primary Specialty | CLINICAL PSYCHOLOGIST |
| Group Practice PAC ID | 0941288302 |
| Number of Group Practice Members | 15 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 313 3rd St, Kamiah, ID 83536-5054 | 2089350733 | NEZ PERCE TRIBAL HEALTH AUTHORITY |
| 111 Bever Grade Rd, Lapwai, ID 83540 | 2088432271 | NEZ PERCE TRIBAL HEALTH AUTHORITY |
| Organization Legal Name | NEZ PERCE TRIBAL HEALTH AUTHORITY |
| Physicians | 13 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Penny R Buckland | Nurse Practitioner | Nez Perce Tribal Health Authority | 313 3rd St, Kamiah, ID 83536-5054 |
| Ileen S Huh | Optometry | Nez Perce Tribal Health Authority | 111 Bever Grade Rd, Nimiipuu Health, Lapwai, ID 83540-0367 |
| Korena Lynn Popp | Nurse Practitioner | Nez Perce Tribal Health Authority | 313 3rd St, Kamiah, ID 83536-5054 |
| Thanh Danae N Vu | Obstetrics/gynecology | Nez Perce Tribal Health Authority | 111 Bever Grade Rd, Nimiipuu Health, Lapwai, ID 83540-0367 |
| Karen M Hendren | Clinical Social Worker | Nez Perce Tribal Health Authority | 313 3rd St, Kamiah, ID 83536-5054 |
| Roxie K Hartwig | Family Medicine | Nez Perce Tribal Health Authority | 313 3rd St, Kamiah, ID 83536-5054 |
| Dustin K Worth | Osteopathic Manipulative Medicine | Nez Perce Tribal Health Authority | 111 Bever Grade Rd, Nimiipuu Health, Lapwai, ID 83540-0367 |
| Miles F Robinson | Nurse Practitioner | Nez Perce Tribal Health Authority | 313 3rd St, Kamiah, ID 83536-5054 |
| Carysa M Dugan | Physical Therapy | Nez Perce Tribal Health Authority | 111 Bever Grade Rd, Lapwai, ID 83540 |
| Janis J Whitehead | Nurse Practitioner | Nez Perce Tribal Health Authority | 313 3rd St, Kamiah, ID 83536-5054 |
| Street Address |
111 BEVER GRADE RD |
| City | LAPWAI |
| State | ID |
| Zip | 83540 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ileen S Huh | Optometry | Nez Perce Tribal Health Authority | 111 Bever Grade Rd, Nimiipuu Health, Lapwai, ID 83540-0367 |
| Thanh Danae N Vu | Obstetrics/gynecology | Nez Perce Tribal Health Authority | 111 Bever Grade Rd, Nimiipuu Health, Lapwai, ID 83540-0367 |
| Dustin K Worth | Osteopathic Manipulative Medicine | Nez Perce Tribal Health Authority | 111 Bever Grade Rd, Nimiipuu Health, Lapwai, ID 83540-0367 |
| Carysa M Dugan | Physical Therapy | Nez Perce Tribal Health Authority | 111 Bever Grade Rd, Lapwai, ID 83540 |
| Dean H Hattan | Optometry | Nez Perce Tribal Health Authority | 111 Bever Grade Rd, Lapwai, ID 83540 |
| City | LAPWAI |
| Zip Code | 83540 |
| Specialty | CLINICAL PSYCHOLOGIST |
| City + Specialty | LAPWAI + CLINICAL PSYCHOLOGIST |
Please comment or provide details below to improve the information on Gary L Grogan.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.