Provider Demographics
NPI:1598108110
Name:GRUBBS, NATHANIEL GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:GEORGE
Last Name:GRUBBS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1200 N BEAVER ST
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-3118
Mailing Address - Country:US
Mailing Address - Phone:928-213-6235
Mailing Address - Fax:928-213-6292
Practice Address - Street 1:3700 W STATE ROUTE 89A
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336
Practice Address - Country:US
Practice Address - Phone:928-204-4100
Practice Address - Fax:928-204-4115
Is Sole Proprietor?:No
Enumeration Date:2013-04-12
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ54828207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine