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Contact Information

JEFFREY S GRUNER, MD
1200 N BEAVER ST
FLAGSTAFF, AZ86001-3118
 Phone: 928-773-2200
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical Critical Care

2086S0102X 02 Physician/General Surgery
 

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for JEFFREY S GRUNER · (Male)

NPI Number 1073515862
Status Active
Credentials MD
Entity Individual
Enumeration date 08/11/2005
Last updated 07/17/2025 - About 11 months ago
Sole proprietor 1 No
Identifiers
  • AZ License # 77713
  • LA License # 023672
  • LA Medicaid 1486795
  • LA Other 7194459 AETNA
  • LA Other 195344 COVENTRY
  • LA Other 900070463GR OSCHNER
  • LA Other DA0978 RAILROAD MEDICARE
  • LA Other P00012293 RAILROAD MEDICARE PIN#
  • LA Other 1700784 UNITED HEALTHCARE
Hospital affiliation(s)
  • OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER - (Acute Care)
    5000 HENNESSY BLVD
    BATON ROUGE, LA 70808
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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