| Carlie Alexandra Grigg, | |
|
9130 R G Skinner Parkway, Jacksonville, FL 32256 | |
| (904) 538-0950 | |
| (904) 538-0952 |
| Full Name | Carlie Alexandra Grigg |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 9130 R G Skinner Parkway, Jacksonville, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891209870 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA185615 (Oregon) | Secondary |
| 363A00000X | Physician Assistant | PA9113179 (Florida) | Primary |
| Entity Name | Grants Pass Clinic LLP |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760418032 PECOS PAC ID: 9234123977 Enrollment ID: O20040414000467 |
| Mailing Address | Practice Location Address |
|---|---|
| Carlie Alexandra Grigg, 9130 R G Skinner Parkway, Jacksonville, FL 32256 Ph: (904) 538-0950 | Carlie Alexandra Grigg, 9130 R G Skinner Parkway, Jacksonville, FL 32256 Ph: (904) 538-0950 |
Katherine L Walsh, PA-C/MPH Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000 |
Teresa Louise Cowan, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1200 Riverplace Blvd, Suite 620, Jacksonville, FL 32207 Phone: 904-396-6620 Fax: 904-396-6528 |
Mrs. Melina Volner Sommese, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2594 Fax: 904-953-6225 |
Mr. Thomas Matthew Mattox Jr., PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 15255 Max Leggett Pkwy Ste 5500, Jacksonville, FL 32218 Phone: 904-223-3321 |
Kyle Hollingsworth, PA-C, ATC Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 710 Lomax St, Jacksonville, FL 32204 Phone: 904-355-6583 |
Jessica Defazio, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 836 Prudential Dr Ste 1400, Jacksonville, FL 32207 Phone: 904-388-6518 Fax: 904-384-1005 |
Hangyu Shen Watson, M.D. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000 |