Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 16657 | AL |
NPI | 1073558813 |
---|---|
Provider Name | Carol A Griffin |
First Address | Birmingham, AL 35255-5310 |
Second Address | Birmingham, AL 35205-3703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2006 |
Last Update Date | 06/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
051113501 | BCBS (01) | AL |
051113502 | BCBS (01) | AL |
051113503 | BCBS (01) | AL |
051113504 | BCBS (01) | AL |
051113506 | BCBS (01) | AL |
05904212 | (05) | MS |
125975 | (05) | AL |
125976 | (05) | AL |
125977 | (05) | AL |
125978 | (05) | AL |
125979 | (05) | AL |