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

Mr. Bruce Grissom Jr.

Individual provider Family Medicine Physician · NPI 1720513617

Mr. Bruce Grissom Jr. is a Family Practice in Purvis, Mississippi. Graduated from William Carey University College of Osteopathic Medicine in 2017, 9 years ago. Practices with Hattiesburg Clinic PA, a 530-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
9
Trained at
William Carey University College of Osteopathic Medicine
Licensed in
MS
In the registry since
2017

Practice location Address checks out

102 Shelby Speights Dr
Purvis, MS 39475-4151
Phone: (601) 794-8065
Fax: (601) 794-5650
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 27862 (MS)

Record details

NPI number1720513617
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 27, 2017
Last updated in NPPESAugust 27, 2020
Certification dateAugust 27, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolWILLIAM CAREY UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduated 2017 (9 years in practice)
Group practice Hattiesburg Clinic Pa — 530 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Purvis