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General NPI Number Information
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NPI Number | 1023471901
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Entity Type | Individual
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Provider Name | DAVID R GRIFFIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/30/2016
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Last Update Date | 06/08/2020
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Provider Practice Location Address
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Address Line | 1972 W GROVE PKWY STE 300
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-8406
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Country | US
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Telephone | 801-476-0494
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Fax | 801-221-1052
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Provider Business Mailing Address
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Address Line | PO BOX 30015 DPT 93
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City | SALT LAKE CITY
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State | UT
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Zip | 84130-0015
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Country | US
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Telephone | 801-476-0494
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Fax | 801-479-3937
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 32749
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 11713637-1205
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License Number State | UT
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