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General NPI Number Information
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NPI Number | 1558453381
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Entity Type | Organization
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Legal Business Name | RICHARD A GRIFFIN, OD & ASSOCIATES, LLC
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 11/10/2014
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Provider Practice Location Address
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Address Line | 6405 W NEWBERRY RD
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City | GAINESVILLE
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State | FL
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Zip | 32605-4338
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Country | US
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Telephone | 352-222-1677
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Fax |
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Provider Business Mailing Address
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Address Line | 409 SW 129TH TER
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City | NEWBERRY
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State | FL
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Zip | 32669-2761
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Country | US
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Telephone | 352-222-1677
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD A GRIFFIN
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Credential |
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Telephone | 352-222-1677
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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 | OPC001225
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License Number State | FL
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