Healthcare Provider Details

I. General information

NPI: 1912128521
Provider Name (Legal Business Name): JEFFREY D GRIFFIN M.S.,CCC-A
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 11/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 15TH AVE S, STE 207
GREAT FALLS MT
59405-4334
US

IV. Provider business mailing address

401 15TH AVE S, STE 207
GREAT FALLS MT
59405-4334
US

V. Phone/Fax

Practice location:
  • Phone: 406-727-6577
  • Fax: 406-727-6577
Mailing address:
  • Phone: 406-727-6577
  • Fax: 406-727-6577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number395
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number150
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: