Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 107007 | MN |
Y | 207YS0123X | Facial Plastic Surgeon | 57227 | MN |
NPI | 1326169160 |
---|---|
Provider Name | Dr. Garrett R Griffin |
First Address | Woodbury, MN 55125-2523 |
Second Address | Woodbury, MN 55125 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 16/08/2018 |