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General NPI Number Information
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NPI Number | 1528197282
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Entity Type | Individual
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Provider Name | DANIEL MATTHEW GRIFFITT O.D.
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Gender | Male
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5000 SHELBYVILLE RD J.C. PENNEY OPTICAL
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City | LOUISVILLE
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State | KY
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Zip | 40207-3342
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Country | US
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Telephone | 502-895-5373
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Fax |
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Provider Business Mailing Address
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Address Line | 1104 DOEBROOK DR
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City | NEW ALBANY
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State | IN
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Zip | 47150-2093
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Country | US
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Telephone | 812-949-0590
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1299DT
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License Number State | KY
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