NPI 1023241403

Kirk Anthony Grantham, MD

Practitioner Family Medicine Physician Shreveport, LA

Practice location

Address: 2530 Bert Kouns Loop Suite 138, Shreveport, LA 71118-3132
Phone: (318) 588-4726
Fax: (318) 900-7828
Mailing address: PO Box 1264, Benton, LA 71006-1264

Registered specialties (2)

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence MD.205467 (LA)

Other Family Medicine providers in Louisiana →

Family Medicine Physician

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence TRN 14355 (FL)

Registry record

NPI: 1023241403
Entity type: Individual
Sex (as registered): Male
NPI issued: 1 Sep 2009
Record last updated: 8 Jun 2021

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.