Healthcare Provider Details

I. General information

NPI: 1881659761
Provider Name (Legal Business Name): JEFFREY F GRIFFIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 03/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 GALLERIA DR STE 303
METAIRIE LA
70001-2196
US

IV. Provider business mailing address

4224 HOUMA BLVD SUITE 540
METAIRIE LA
70006-2933
US

V. Phone/Fax

Practice location:
  • Phone: 504-456-5108
  • Fax:
Mailing address:
  • Phone: 504-456-5108
  • Fax: 504-456-5109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number012802
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: