Provider Demographics
NPI:1346341732
Name:GRIFFIN, ELIZABETH JANE (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:JANE
Last Name:GRIFFIN
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 1:340 SEMINARY ST
Mailing Address - Street 2:DUPLIN COUNTY HEALTH DEPARTMENT
Mailing Address - City:KENANSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28349-8978
Mailing Address - Country:US
Mailing Address - Phone:910-296-2130
Mailing Address - Fax:910-296-2139
Practice Address - Street 1:340 SEMINARY ST
Practice Address - Street 2:
Practice Address - City:KENANSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28349-8978
Practice Address - Country:US
Practice Address - Phone:910-296-2130
Practice Address - Fax:910-296-2139
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34018208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC37352OtherBCBS NC
NC7937352Medicaid
NC3404430Medicaid
NCF41107Medicare UPIN