Doctor Name: | JOHN T. GRANDONE |
NPI Number: | 1467480681 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 21696 |
Business Practice Address: | 200 Theda Clark Medical Plz Suite 350 Neenah, WI - 549562721 |
Business Phone Number: | 9207292710 |
Business Fax Number: | 9207274511 |
Mailing Address: | Po Box 8003, APPLETON |
State: | WI |
Postal Code: | 549128003 |
Phone Number: | 9209963200 |
Fax Number: | 9207385787 |
NPI Enumeration Date: | 06/28/2006 |
NPI Last Update Date: | 10/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 21696 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WI |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |