Provider Demographics
NPI:1245200385
Name:GRIFFITH, LINDA J (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:J
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 S LIMESTONE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45505-1965
Mailing Address - Country:US
Mailing Address - Phone:937-328-7266
Mailing Address - Fax:937-328-7257
Practice Address - Street 1:651 S LIMESTONE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45505
Practice Address - Country:US
Practice Address - Phone:937-328-7266
Practice Address - Fax:937-328-7257
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35075659G2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2241087Medicaid
OHGR4042661Medicare ID - Type Unspecified
OH2241087Medicaid