Provider Demographics
NPI:1821484593
Name:GRUBBS, JEFFREY
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:GRUBBS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:771 DEARBORN PARK LN
Mailing Address - Street 2:SUITE N
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43085-5720
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:771 DEARBORN PARK LN
Practice Address - Street 2:SUITE N
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43085-5720
Practice Address - Country:US
Practice Address - Phone:614-452-7300
Practice Address - Fax:614-452-7301
Is Sole Proprietor?:No
Enumeration Date:2015-04-09
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other