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General NPI Number Information
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NPI Number | 1386614709
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Entity Type | Individual
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Provider Name | GAIL T GRIFFIN MD
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Gender | Female
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 06/11/2018
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Provider Practice Location Address
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Address Line | 4155 COUNTY ROAD 101 N
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City | PLYMOUTH
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State | MN
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Zip | 55446
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Country | US
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Telephone | 952-993-8955
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Fax |
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Provider Business Mailing Address
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Address Line | 4155 COUNTY ROAD 101 N
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City | PLYMOUTH
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State | MN
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Zip | 55446-2307
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Country | US
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Telephone | 952-993-8955
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D0055104
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 63350
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License Number State | MN
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