Herbert Galen Grantham, M.D.
Individual provider Active NPI Anatomic Pathology & Clinical Pathology Physician · Fort Scott, KS
NPI 1790883643 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1790883643
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
- License
- 04-20707 (KS)
- Practice address
- 701 W 8TH St
Fort Scott, KS 66701-2403 - Phone
- (620) 223-5032
- Fax
- (620) 223-5071
- NPI assigned
- Sep 21, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04-20707 | KS | MD | Anatomic Pathology & Clinical Pathology Physician |
| MDR6E98 | MO | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Pathology Consultants, P.a. | Anatomic Pathology & Clinical Pathology | Current |
Accepting new patients |
Locations
401 Woodland Hills Blvd
Fort Scott, KS 66701
Phone (620) 223-2200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 04-20707 | KS | Yes |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | MDR6E98 | MO |
Addresses
Primary practice location
701 W 8TH St
Fort Scott, KS 66701-2403
Mailing address
701 W 8TH St
Fort Scott, KS 66701-2403
Phone (620) 223-5032
Other providers in Fort Scott, KS
- Ft Scott Surgery Center LLC
- Irvin Garcia-Augur
- Crystal Star Garcia
- Hannah Geneva
- Dean Taylor Gettler
- Growing Perspectives Counseling, LLC
- Guest Home Estates of Ft Scott,LLC
- Pankaj Gugnani
- William H Guilfoyle
- Ralph Warren Hall
All providers in Fort Scott, KS · Anatomic Pathology & Clinical Pathology Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.