Healthcare Provider Details

I. General information

NPI: 1659480002
Provider Name (Legal Business Name): JOSHUA KEITH GRIFFIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 LACEY ST
CAPE GIRARDEAU MO
63701-5230
US

IV. Provider business mailing address

721 N SUNSET BLVD
CAPE GIRARDEAU MO
63701-4532
US

V. Phone/Fax

Practice location:
  • Phone: 573-335-0185
  • Fax: 573-335-0793
Mailing address:
  • Phone: 573-335-0185
  • Fax: 573-335-0793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number2006009452
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number2006009452
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2006009452
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME147731
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: