Individual provider · Type 1 NPI

Mark E. Grandon, PA-C

Surgical Physician Assistant · Louisville, KY

NPI number 1386683852 Active

Practice location

3 Audubon Plaza Dr, Suite 560
Louisville, KY 40217-1319

Call (502) 636-8004 Map

Fax (502) 636-8384

Mailing address

PO Box 776351
Chicago, IL 60677-6351

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XPA155 (KY)

Surgical Physician Assistant: Definition to come...

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About NPI 1386683852

Mark E. Grandon, PA-C's National Provider Identifier is 1386683852, issued on Jun 6, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Louisville, KY. The record was last updated on Jul 9, 2016.