Provider Demographics
NPI:1003347915
Name:GRAND, JACOB (MD)
Entity type:Individual
Prefix:MR
First Name:JACOB
Middle Name:
Last Name:GRAND
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4230 HARDING PIKE STE 330
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2018
Mailing Address - Country:US
Mailing Address - Phone:615-565-6586
Mailing Address - Fax:
Practice Address - Street 1:5201 CHARLOTTE PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-3320
Practice Address - Country:US
Practice Address - Phone:314-276-9282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-22
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program