Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 022791 | GA |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 022791 | GA |
NPI | 1164424198 |
---|---|
Provider Name | Dr. Letha Yurko Griffin |
First Address | Atlanta, GA 30309-1476 |
Second Address | Atlanta, GA 30309-1414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 14/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00238653A1 | (05) | GA |
0486290001 | DME (01) | GA |