Provider Demographics
NPI:1851360010
Name:GRANT, JOEL T (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:T
Last Name:GRANT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:160 WARRIOR DR
Mailing Address - Street 2:
Mailing Address - City:STEPHENS CITY
Mailing Address - State:VA
Mailing Address - Zip Code:22655-4044
Mailing Address - Country:US
Mailing Address - Phone:540-868-4100
Mailing Address - Fax:540-868-0888
Practice Address - Street 1:160 WARRIOR DR
Practice Address - Street 2:
Practice Address - City:STEPHENS CITY
Practice Address - State:VA
Practice Address - Zip Code:22655-4044
Practice Address - Country:US
Practice Address - Phone:540-868-4100
Practice Address - Fax:540-868-0888
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101233394207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA75787OtherCOMMUNITY HEALTH
VA0107195OtherUNITED HEALTHCARE VA
VA861102088OtherTAX ID AMERIHLTH, TRICARE
VA9588527OtherCIGNA
VA010080029Medicaid
VA2124718OtherMAMSI
VA0107692OtherUNITED HEALTHCARE
VA137798OtherANTHEM
VA242915OtherSOUTHERN HEALTH
VA242915OtherSOUTHERN HEALTH
VA00W317S01Medicare ID - Type UnspecifiedMEDICARE