Provider Demographics
NPI:1649277690
Name:MCGRANN, JAMES R (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:MCGRANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4950 S MINNESOTA AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2864
Mailing Address - Country:US
Mailing Address - Phone:605-330-9619
Mailing Address - Fax:605-330-9503
Practice Address - Street 1:4950 S MINNESOTA AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2864
Practice Address - Country:US
Practice Address - Phone:605-330-9619
Practice Address - Fax:605-330-9503
Is Sole Proprietor?:No
Enumeration Date:2005-07-06
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD1216207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5900132Medicaid
SD4850Medicare ID - Type UnspecifiedMEDICARE#
SD5900132Medicaid