Provider Demographics
NPI:1326054206
Name:GRIFFITH, KRISTY (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTY
Middle Name:
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 1:3105 E SKELLY DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-6358
Mailing Address - Country:US
Mailing Address - Phone:918-599-7404
Mailing Address - Fax:
Practice Address - Street 1:3105 E SKELLY DR
Practice Address - Street 2:SUITE 310
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-6358
Practice Address - Country:US
Practice Address - Phone:918-599-7404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK224522084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100091500BMedicaid
OK1122452Medicare ID - Type Unspecified