Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 11713637-1205 | UT |
N | 207W00000X | Ophthalmologist | 32749 | OK |
NPI | 1023471901 |
---|---|
Provider Name | Dr. David R Griffin |
First Address | Salt Lake City, UT 84130-0015 |
Second Address | Pleasant Grove, UT 84062-8406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2016 |
Last Update Date | 08/06/2020 |