Provider Demographics
NPI:1548235476
Name:GRIN, MILTON B (MD)
Entity Type:Individual
Prefix:DR
First Name:MILTON
Middle Name:B
Last Name:GRIN
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 1:21020 W 151ST ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-7200
Mailing Address - Country:US
Mailing Address - Phone:913-829-5511
Mailing Address - Fax:913-829-5571
Practice Address - Street 1:21020 W 151ST ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-7200
Practice Address - Country:US
Practice Address - Phone:913-829-5511
Practice Address - Fax:913-829-5571
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR8F92207W00000X
KS0422448207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS180036250OtherRAILROAD MEDICARE
KS10118590BMedicaid
KS6367830001Medicare NSC
KS10118590BMedicaid
D93549Medicare UPIN
KSK380654Medicare PIN