Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 296 | AL |
Y | 222Z00000X | Podiatrist | 296 | AL |
N | 213EP1101X | Primary Podiatric Medicine | 296 | AL |
N | 213ES0103X | Foot & Ankle Surgery | 296 | AL |
N | 213ES0103X | Foot & Ankle Surgery | PO3271 | FL |
N | 213ES0131X | Foot Surgery | 296 | AL |
NPI | 1477731313 |
---|---|
Provider Name | Dr. Joe B. Griffin |
First Address | Daphne, AL 36526-9569 |
Second Address | Daphne, AL 36526-9569 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2008 |
Last Update Date | 27/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
511-11527 | BCBS ANTHEM (01) | AL |
9387177 | AETNA (01) | AL |