| Doctor Name: | WILLIAM R GRIMES |
| NPI Number: | 1962590364 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ARNP |
| License Number: | 630P |
| Business Practice Address: | 632 Slate Avenue Owingsville, KY - 40360 |
| Business Phone Number: | 6066746386 |
| Business Fax Number: | 6066743096 |
| Mailing Address: | Po Box 1120, OWINGSVILLE |
| State: | KY |
| Postal Code: | 403601120 |
| Phone Number: | 6066746386 |
| Fax Number: | 6066743096 |
| NPI Enumeration Date: | 10/11/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 630P |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |