MEDICARE: GRIFFYTH RICHARD PA-C

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	363AM0700X	Medical Physician Assistant	344	MT
2	363AM0700X	Medical Physician Assistant	340	WY

General Provider Information

NPI Number	:	1629264882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRIFFYTH RICHARD PA-C

Provider Business Mailing Address
First Line	:	2224 US HIGHWAY 87 E
Second Line	:	#245
City	:	BILLINGS
State	:	MT
Zip	:	59101-6660
Country	:	US
Telephone Number	:	406-534-3321
Fax Number	:

Provider Business Practice Location Address
First Line	:	3318 3RD AVE N
Second Line	:	SUITE 100
City	:	BILLINGS
State	:	MT
Zip	:	59101-1900
Country	:	US
Telephone Number	:	406-248-3149
Fax Number	:	406-245-6636

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

Provider Enumeration Date	:	09/21/2007
Last Update Date	:	09/21/2007

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Directions to “ GRIFFYTH RICHARD PA-C” Practice Location

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