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General NPI Number Information
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NPI Number | 1134153018
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Entity Type | Individual
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Provider Name | RYAN LEIGH GRIFFIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 11/30/2007
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Provider Practice Location Address
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Address Line | 922 E CALL ST
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City | STARKE
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State | FL
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Zip | 32091-3616
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Country | US
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Telephone | 904-368-2300
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Fax | 904-368-2306
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Provider Business Mailing Address
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Address Line | PO BOX 100371
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City | GAINESVILLE
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State | FL
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Zip | 32610-0371
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Country | US
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Telephone | 352-338-2195
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Fax | 352-338-2185
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME96167
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME96167
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME96167
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License Number State | FL
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