Healthcare Provider Details

I. General information

NPI: 1437199056
Provider Name (Legal Business Name): BRIAN KEITH GRIFFITH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4522 MACCORKLE AVE SE
CHARLESTON WV
25304-1840
US

IV. Provider business mailing address

501 SUMMERS ST
CHARLESTON WV
25301-1239
US

V. Phone/Fax

Practice location:
  • Phone: 304-982-8246
  • Fax: 304-345-1801
Mailing address:
  • Phone: 304-343-3937
  • Fax: 304-344-3957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberWV21067
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: