Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
CLYDE GRADY
ActiveCLYDE GRADY is a Family Medicine healthcare provider located in KNOXVILLE, Illinois. NPI 1851484075 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · KNOXVILLE, IL
Registration Details
- NPI Number
- 1851484075
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 2, 2006 (19.863176635494 yrs)
- Last Updated
- Jul 8, 2007
Practice Information
- Address
-
104 S BROAD STKNOXVILLE, IL, 614481339Browse IL providers · Browse ZIP 61448
- Phone
- 3092892335
- Fax
- 3092898196
- Primary Specialty
-
Family Medicine
207Q00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.