James Alan Grogan, PA

Individual provider Active NPI Medical Physician Assistant · Lexington, MI

NPI 1003932476 · NPPES record last updated Oct 7, 2016

Key facts

NPI
1003932476
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
5601001722 (MI)
Practice address
5730 Main St
Lexington, MI 48450-8800
Phone
(810) 696-2088
Fax
(810) 696-2088
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: jgrogan58719@direct.hfhs.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601001722 MI
Medical Physician Assistant 363AM0700X 5601001722 MI Yes

Addresses

Primary practice location

5730 Main St
Lexington, MI 48450-8800

Mailing address

5730 Main St
Lexington, MI 48450-8800
Phone (810) 696-2088

Other identifiers

IdentifierTypeStateIssuer
382516038OtherMIGROUP PRACTICE TAX ID NUM

Other providers in Lexington, MI

All providers in Lexington, MI · Medical Physician Assistant in Michigan

Sources for this page

Verify at the official NPI Registry.