Provider Demographics
NPI:1336282011
Name:GRIFFIN, JENNY MARIE (DO)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:MARIE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274 EASTCHESTER DR STE 120
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7721
Mailing Address - Country:US
Mailing Address - Phone:336-542-2992
Mailing Address - Fax:
Practice Address - Street 1:274 EASTCHESTER DR STE 120
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7721
Practice Address - Country:US
Practice Address - Phone:336-542-2992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0072170207Q00000X
NH23929207Q00000X
MO2006032132207Q00000X
WAOP61501147207Q00000X
MA1013153207Q00000X
GA95428207Q00000X
NC2019-00248207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine