Provider Demographics
NPI:1346391364
Name:GRIFFIN, JAMES MARK (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MARK
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70510-5146
Mailing Address - Country:US
Mailing Address - Phone:337-893-6995
Mailing Address - Fax:
Practice Address - Street 1:123 N STATE ST
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510-5146
Practice Address - Country:US
Practice Address - Phone:337-893-6995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1351111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4H416CP50Medicare PIN