Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Grenada Lake Medical Center

Organization Orthopaedic Surgery Physician · NPI 1922187095

Grenada Lake Medical Center is an Orthopaedic Surgery Physician in Grenada, Mississippi. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

960 J K Avent Dr
Grenada, MS 38901-5230
Phone: (662) 227-7000
Fax: (662) 227-7534
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X

Record details

NPI number1922187095
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Charles Denton — Ceo · (662) 227-7000
Other names Grenada Specialty Clinic (Gsc)
NPI enumeratedNovember 2, 2006
Last updated in NPPESMarch 4, 2011
Mailing address960 J K Avent Dr, Grenada, MS 38901-5230

Other providers in Grenada