MEDICARE: GARY S GRIFFIN MD

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
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	2788561205	UT
2	207R00000X	Internal Medicine Physician	044731	GA
3	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	044731	GA

General Provider Information

NPI Number	:	1245307735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY S GRIFFIN MD

Provider Business Mailing Address
First Line	:	4300 N POINT PKWY STE 300
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30022-4102
Country	:	US
Telephone Number	:	770-442-1911
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 CORPORATE SQ
Second Line	:
City	:	DUBLIN
State	:	GA
Zip	:	31021-4244
Country	:	US
Telephone Number	:	478-272-2599
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	10/21/2025

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