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NPI Code Detail

MEDICARE: WALTER P. GRIFFEY JR MD PC

MEDICARE: WALTER P. GRIFFEY JR MD PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist

General Provider Information

NPI Number : 1225088818
Entity Type Code : Organization
Provider Name (Legal Business Name) : WALTER P. GRIFFEY JR MD PC
Provider Business Mailing Address
First Line : 430 S LAKE ST
Second Line :
City : PARIS
State : TN
Zip : 38242-4573
Country : US
Telephone Number : 731-642-3024
Fax Number : 731-642-3028
Provider Business Practice Location Address
First Line : 430 S LAKE ST
Second Line :
City : PARIS
State : TN
Zip : 38242-4573
Country : US
Telephone Number : 731-642-3024
Fax Number : 731-642-3028
Authorized Official
Title or Position : PRESIDENT
Name : WALTER P GRIFFEY III
Credential : M.D.
Telephone Number : 731-642-3024
Provider Enumeration Date : 05/12/2006
Last Update Date : 07/13/2010

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