Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | MD00049437 | WA |
N | 2081P2900X | Pain Medicine | MD156621 | OR |
NPI | 1184787491 |
---|---|
Provider Name | Dr. John B Groner |
First Address | Kennewick, WA 99338-2908 |
Second Address | Kennewick, WA 99338-2908 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 12/08/2021 |