Provider Demographics
NPI:1306224175
Name:GRANT, ANTHONY WILLIAM (DPM)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:WILLIAM
Last Name:GRANT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2010
Mailing Address - Street 2:
Mailing Address - City:WINTERSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43953-0010
Mailing Address - Country:US
Mailing Address - Phone:740-264-4200
Mailing Address - Fax:740-264-9403
Practice Address - Street 1:319 MAIN ST
Practice Address - Street 2:
Practice Address - City:WINTERSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43953
Practice Address - Country:US
Practice Address - Phone:740-264-4200
Practice Address - Fax:740-264-9403
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-13
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.003888213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty