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

Mr. Mark Leslie Grogan

Individual provider Physical Therapy Assistant · NPI 1811292501

Mr. Mark Leslie Grogan is a Physical Therapy Assistant in Madison, Mississippi. Licensed in Mississippi. Registered with an NPI since 2011.

Licensed in
MS
In the registry since
2011

Practice location Address checks out

401 Baptist Dr Ste 306
Madison, MS 39110-2009
Phone: (601) 607-7204
Fax: (601) 607-7430
Show map & directions

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

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence PTA4334 (MS)

Record details

NPI number1811292501
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 11, 2011
Last updated in NPPESJanuary 11, 2011
Mailing address401 Baptist Dr, Suite 306, Madison, MS 39110-2009

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