| Chris L Granger M D LLC | |
|
403 W 8th St Deridder LA 70634-5507 | |
| (337) 463-8977 | |
| Not Available |
| Full Name | Chris L Granger M D LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 403 W 8th St, Deridder, Louisiana |
| Authorized Official Name and Position | Christopher Lee Granger (PHYSICIAN) |
| Authorized Official Contact | 3374638977 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chris L Granger M D LLC 403 W 8th St Deridder LA 70634-5507 | Chris L Granger M D LLC 403 W 8th St Deridder LA 70634-5507 Ph: (337) 463-8977 |
| NPI Number | 1467632299 |
|---|---|
| Provider Enumeration Date | 11/08/2007 |
| Last Update Date | 12/06/2011 |
| Medicare PECOS PAC ID | 9133158355 |
|---|---|
| Medicare Enrollment ID | O20050809000021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467632299 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2000.31 (Louisiana) | Primary |
| Provider Name | Christopher Granger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861472110 PECOS PAC ID: 0648230854 Enrollment ID: I20050810000033 |
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