MEDICARE: DR. PATRICIA L GRIFFITH 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	016203	ME

General Provider Information

NPI Number	:	1750457016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICIA L GRIFFITH M.D.

Provider Business Mailing Address
First Line	:	PO BOX 57915
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84157-0915
Country	:	US
Telephone Number	:	800-341-5095
Fax Number	:

Provider Business Practice Location Address
First Line	:	4021 S 700 E STE 300
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84107-2184
Country	:	US
Telephone Number	:	800-341-5095
Fax Number	:

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

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	07/08/2007

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