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General NPI Number Information
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NPI Number | 1598949745
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Entity Type | Organization
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Legal Business Name | GRIFFITH CLINIC A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 12/24/2007
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Last Update Date | 06/01/2011
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Provider Practice Location Address
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Address Line | 5962 COPLE HWY
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City | MOUNT HOLLY
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State | VA
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Zip | 22524-9999
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Country | US
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Telephone | 804-472-2477
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Fax | 804-472-3154
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Provider Business Mailing Address
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Address Line | PO BOX 31354
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City | RICHMOND
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State | VA
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Zip | 23294-1354
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Country | US
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Telephone | 804-472-2477
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Fax | 804-472-3124
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Authorized Official
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Title or Position | BILLING MGR
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Name | ROBIN G FEAGANES
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Credential |
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Telephone | 540-885-1045
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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 | 0101012891
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License Number State | VA
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