MEDICARE: THOMAS SIGURD GRIGGS 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	2085R0202X	Diagnostic Radiology Physician	19576	OK

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	:	1891743373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS SIGURD GRIGGS MD

Provider Business Mailing Address
First Line	:	3600 NW 138TH ST
Second Line	:	SUITE 102
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73134-2503
Country	:	US
Telephone Number	:	405-286-4114
Fax Number	:	405-463-0154

Provider Business Practice Location Address
First Line	:	3600 NW 138TH ST
Second Line	:	SUITE 102
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73134-2503
Country	:	US
Telephone Number	:	405-286-4114
Fax Number	:	405-463-0154

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

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	11/04/2014

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