NPI 1104007558

Lee Grimm, M.D., P.C.

Organisation Specialist Southaven, MS

Practice location

Address: 7580 Clarington Cv Suite 3, Southaven, MS 38671-5657
Phone: (423) 854-0001
Fax: (423) 854-0002
Mailing address: 3101 Browns Mill Rd Suite 6, Johnson City, TN 37604-4100

Authorised official

Name: Lee M Grimm
Title: Owner
Phone: (423) 854-0001

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 12705 (MS)

Other Specialist providers in Mississippi →

Registry record

NPI: 1104007558
Entity type: Organization
NPI issued: 14 Nov 2007
Record last updated: 12 Mar 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.