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General NPI Number Information
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NPI Number | 1528087038
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Entity Type | Individual
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Provider Name | GARY L GRIFFITH MD
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Gender | Male
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 10590 N MERIDIAN ST SUITE 105
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City | INDIANAPOLIS
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State | IN
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Zip | 46290-1028
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Country | US
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Telephone | 317-583-7800
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Fax | 317-583-7807
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Provider Business Mailing Address
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Address Line | 8433 HARCOURT ROAD SUITE 300
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-2190
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Country | US
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Telephone | 317-583-7600
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Fax | 317-583-7601
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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 | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 01033653A
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License Number State | IN
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