Provider Demographics
NPI:1326150368
Name:GRIFFITH, ALLISON JEAN (OD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:JEAN
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 JAMES EPPS ROAD, STE. 1
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616
Mailing Address - Country:US
Mailing Address - Phone:417-334-7291
Mailing Address - Fax:417-334-6156
Practice Address - Street 1:1000 JAMES EPPS ROAD, STE. 1
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616
Practice Address - Country:US
Practice Address - Phone:417-334-7291
Practice Address - Fax:417-334-6156
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006020341152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0059FCOtherBLUE CROSS
MO0420260003Medicare NSC
MOU71503Medicare UPIN
MO0420260002Medicare NSC
TX0059FCOtherBLUE CROSS
MOP00373097Medicare PIN