Healthcare Provider Details

I. General information

NPI: 1194701045
Provider Name (Legal Business Name): GRIFFITH ERNEST QUINBY JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2005
Last Update Date: 04/14/2020
Certification Date: 04/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 COLONY DR.
EDGEWOOD KY
41017-2636
US

IV. Provider business mailing address

233 COLONY DR.
EDGEWOOD KY
41017-2636
US

V. Phone/Fax

Practice location:
  • Phone: 859-655-5642
  • Fax:
Mailing address:
  • Phone: 859-655-5642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME72078
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberME72078
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: