Provider Demographics
NPI:1033293980
Name:GROBMYER, ALBERT JOSEPH III
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:JOSEPH
Last Name:GROBMYER
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3175 LENOX PARK BLVD
Mailing Address - Street 2:SUITE 309
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-4260
Mailing Address - Country:US
Mailing Address - Phone:901-273-2600
Mailing Address - Fax:901-761-3786
Practice Address - Street 1:3175 LENOX PARK BLVD
Practice Address - Street 2:SUITE 309
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-4260
Practice Address - Country:US
Practice Address - Phone:901-273-2600
Practice Address - Fax:901-761-3786
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000004663208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNB59215Medicare UPIN