=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396893921
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DONALD W GRIFFIN M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/08/2007
-----------------------------------------------------
Last Update Date | 04/13/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4322 HARDING PIKE STE 314
-----------------------------------------------------
City | NASHVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37205-2490
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-321-1003
-----------------------------------------------------
Fax | 615-321-1876
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4322 HARDING PIKE STE 314
-----------------------------------------------------
City | NASHVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37205-2490
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-321-1003
-----------------------------------------------------
Fax | 615-321-1876
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208200000X
-----------------------------------------------------
Taxonomy Name | Plastic Surgery Physician
-----------------------------------------------------
License Number | MD021852
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------