Provider Demographics
NPI:1679845655
Name:MCGRANAHAN, THOMAS TIMMONS SR (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:TIMMONS
Last Name:MCGRANAHAN
Suffix:SR
Gender:M
Credentials:MD
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Mailing Address - Street 1:18160 COTTONWOOD RD
Mailing Address - Street 2:# 793
Mailing Address - City:SUNRIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97707-9317
Mailing Address - Country:US
Mailing Address - Phone:541-598-2181
Mailing Address - Fax:541-598-2182
Practice Address - Street 1:18160 COTTONWOOD RD
Practice Address - Street 2:# 793
Practice Address - City:SUNRIVER
Practice Address - State:OR
Practice Address - Zip Code:97707-9317
Practice Address - Country:US
Practice Address - Phone:541-598-2181
Practice Address - Fax:541-598-2182
Is Sole Proprietor?:No
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
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Provider Licenses
StateLicense IDTaxonomies
ORMD07267207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C93272Medicare UPIN