Healthcare Provider Details

I. General information

NPI: 1265669642
Provider Name (Legal Business Name): KARL GRIFFITH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2009
Last Update Date: 06/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 WATER ST SUITE 300
KERRVILLE TX
78028-5333
US

IV. Provider business mailing address

321 HUNTSBERRY RDG
KERRVILLE TX
78028-8423
US

V. Phone/Fax

Practice location:
  • Phone: 830-792-3300
  • Fax: 830-792-5771
Mailing address:
  • Phone: 830-895-8627
  • Fax: 830-895-8627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License NumberG5121
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: