Provider Demographics
NPI:1750611075
Name:ANN M. GROOVER, MD, LLC
Entity type:Organization
Organization Name:ANN M. GROOVER, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:M
Authorized Official - Last Name:GROOVER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-602-9234
Mailing Address - Street 1:2945 MILLER FERRY RD SW
Mailing Address - Street 2:SUITE D
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-7538
Mailing Address - Country:US
Mailing Address - Phone:706-602-9234
Mailing Address - Fax:706-602-9235
Practice Address - Street 1:2945 MILLER FERRY RD SW
Practice Address - Street 2:SUITE D
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-7538
Practice Address - Country:US
Practice Address - Phone:706-602-9234
Practice Address - Fax:706-602-9235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0367652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty