Provider Demographics
NPI:1235198680
Name:GRIFFEY, RICHARD THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:THOMAS
Last Name:GRIFFEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 BAYLOR CT
Mailing Address - Street 2:STE C
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3680
Mailing Address - Country:US
Mailing Address - Phone:757-410-9500
Mailing Address - Fax:757-410-9507
Practice Address - Street 1:508 BAYLOR CT
Practice Address - Street 2:STE C
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3680
Practice Address - Country:US
Practice Address - Phone:757-410-9500
Practice Address - Fax:757-410-9507
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101022062207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890691TMedicaid
VAB06137Medicare UPIN
NC890691TMedicaid
VA5199830001Medicare PIN