Healthcare Provider Details

I. General information

NPI: 1427179266
Provider Name (Legal Business Name): GRIFFIN FAMILY MEDICINE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 YORKTOWN DR
ALEXANDRIA LA
71303-3621
US

IV. Provider business mailing address

145 YORKTOWN DR
ALEXANDRIA LA
71303-3621
US

V. Phone/Fax

Practice location:
  • Phone: 318-445-8380
  • Fax: 318-445-9753
Mailing address:
  • Phone: 318-445-8380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPHER GRIFFIN
Title or Position: OWNER
Credential: MD
Phone: 800-639-2519