Dr Jack Holland Grisham, PHD - Psychologist in Marietta, GA

Dr Jack Holland Grisham, PHD is a Psychologist based in Marietta, Georgia. Dr Jack Holland Grisham is licensed to practice in Georgia (license number 000669) and his current practice location is 122 Cherry St Ne, Marietta, Georgia. He can be reached at his office (for appointments etc.) via phone at (770) 427-2911.

NPI number for Dr Jack Holland Grisham is 1376692061 and his current mailing address is 122 Cherry St Ne, Marietta, Georgia. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1376692061.

Contact Information

Dr Jack Holland Grisham, PHD
122 Cherry St Ne,
Marietta, GA 30060-7206
(770) 427-2911
(770) 422-2302

Map and Direction




Healthcare Provider's Profile

Full NameDr Jack Holland Grisham
GenderMale
SpecialityPsychologist
Location122 Cherry St Ne, Marietta, Georgia
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1376692061
  • Provider Enumeration Date: 01/10/2007
  • Last Update Date: 07/08/2007

Medical Identifiers

Medical identifiers for Dr Jack Holland Grisham such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1376692061NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103T00000XPsychologist 000669 (Georgia)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jack Holland Grisham is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Jack Holland Grisham, PHD
122 Cherry St Ne,
Marietta, GA 30060-7206

Ph: (770) 427-2911
Dr Jack Holland Grisham, PHD
122 Cherry St Ne,
Marietta, GA 30060-7206

Ph: (770) 427-2911

Reviews and Comments


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