DR. TIMOTHY J GRISSOM M.D. NPI 1386695542

NPI Information

DR. Timothy J Grissom, M.D. is a diagnostic radiology radiology in Fort Wayne, IN. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. DR. Timothy J Grissom, M.D. NPI is 1386695542. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2200 RANDALLIA DR
FORT WAYNE, IN
ZIP 46805-638
Phone: (260) 373-4731

The enumeration date for this NPI number is 5/13/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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