MEDICARE: GEORGE D.J. GRIFFIN III M.D.

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	207X00000X	Orthopaedic Surgery Physician	35-038479	OH
2	207X00000X	Orthopaedic Surgery Physician	013782	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538161872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE D.J. GRIFFIN III M.D.

Provider Business Mailing Address
First Line	:	5754 BRIDGETOWN RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45248-3100
Country	:	US
Telephone Number	:	513-481-6100
Fax Number	:	513-481-6954

Provider Business Practice Location Address
First Line	:	5754 BRIDGETOWN RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45248-3100
Country	:	US
Telephone Number	:	513-481-6100
Fax Number	:	513-481-6954

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	12/21/2009

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