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General NPI Number Information
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NPI Number | 1972594919
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Entity Type | Individual
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Provider Name | AMY BARILLEAUX GRIFFIN M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/31/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5408 PROVINE PL
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City | ALEXANDRIA
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State | LA
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Zip | 71303-3772
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Country | US
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Telephone | 318-445-0075
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Fax | 318-445-4142
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Provider Business Mailing Address
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Address Line | 325 BUSH AVE
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City | ALEXANDRIA
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State | LA
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Zip | 71301-5317
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Country | US
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Telephone | 318-473-2324
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 026376
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License Number State | LA
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