Healthcare Provider Details

I. General information

NPI: 1235191933
Provider Name (Legal Business Name): JOHN GRIFFITH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 N 100 W SUITE 103
VERNAL UT
84078-2049
US

IV. Provider business mailing address

175 N 100 W SUITE 103
VERNAL UT
84078-2049
US

V. Phone/Fax

Practice location:
  • Phone: 435-781-1099
  • Fax: 435-781-1090
Mailing address:
  • Phone: 435-781-1099
  • Fax: 435-781-1090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number61485681205
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number61485681205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: