Provider Demographics
NPI:1194216176
Name:GRIFFIN, CEDRIC MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:CEDRIC
Middle Name:MICHAEL
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:7333 E 121ST ST S STE 200
Mailing Address - Street 2:
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008-2654
Mailing Address - Country:US
Mailing Address - Phone:918-403-7140
Mailing Address - Fax:918-856-5392
Practice Address - Street 1:7333 E 121ST ST S STE 200
Practice Address - Street 2:
Practice Address - City:BIXBY
Practice Address - State:OK
Practice Address - Zip Code:74008-2654
Practice Address - Country:US
Practice Address - Phone:918-403-7140
Practice Address - Fax:918-856-5392
Is Sole Proprietor?:No
Enumeration Date:2018-05-24
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK6664207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine