| Jon R Grigg, MD | |
|
St. James & Third Street, Suite 103a, Mansfield, PA 16933 | |
| (570) 662-7600 | |
| (570) 662-7726 |
| Full Name | Jon R Grigg |
|---|---|
| Gender | Male |
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | St. James & Third Street, Mansfield, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720168727 | NPI | - | NPPES |
| 0011677250013 | Medicaid | PA | |
| 0011677250014 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | MD043534E (Pennsylvania) | Primary |
| Entity Name | Concern-professional Services for Children, Youth & Families |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376845479 PECOS PAC ID: 2769659945 Enrollment ID: O20120112000122 |
| Mailing Address | Practice Location Address |
|---|---|
| Jon R Grigg, MD 1873 Shumway Hill Rd, Wellsboro, PA 16901-6840 Ph: (570) 724-5766 | Jon R Grigg, MD St. James & Third Street, Suite 103a, Mansfield, PA 16933 Ph: (570) 662-7600 |
Rosalia R Dominguez, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: St. James & Third St, Suite 103a, Mansfield, PA 16933 Phone: 570-662-7600 Fax: 570-662-7726 |
James E. Manning Iv, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 40 W Wellsboro St, Mansfield, PA 16933 Phone: 570-662-1945 |
Melissa Carin Stokes, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 63 3rd St, Mansfield, PA 16933 Phone: 570-662-7600 Fax: 570-662-7600 |
Dr. Shana S Clark, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 103a Saint James Pl, Mansfield, PA 16933 Phone: 570-662-7600 Fax: 570-662-7726 |