Provider Demographics
NPI:1225088818
Name:WALTER P. GRIFFEY JR MD PC
Entity Type:Organization
Organization Name:WALTER P. GRIFFEY JR MD PC
Other - Org Name:GRIFFEY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:P
Authorized Official - Last Name:GRIFFEY
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:731-642-3024
Mailing Address - Street 1:430 S LAKE ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-4573
Mailing Address - Country:US
Mailing Address - Phone:731-642-3024
Mailing Address - Fax:731-642-3028
Practice Address - Street 1:430 S LAKE ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-4573
Practice Address - Country:US
Practice Address - Phone:731-642-3024
Practice Address - Fax:731-642-3028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty