Provider Demographics
NPI:1275518110
Name:DONA, GRANT ARTHUR (MD)
Entity Type:Individual
Prefix:DR
First Name:GRANT
Middle Name:ARTHUR
Last Name:DONA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 LOUISVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-6025
Mailing Address - Country:US
Mailing Address - Phone:318-323-8451
Mailing Address - Fax:318-361-2613
Practice Address - Street 1:1501 LOUISVILLE AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-6025
Practice Address - Country:US
Practice Address - Phone:318-323-8451
Practice Address - Fax:318-361-2613
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.10522R207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1992861Medicaid
LA1992861Medicaid
LA5U593CY61Medicare PIN
D33760Medicare UPIN