Provider Demographics
NPI:1427020387
Name:GRIFFITHS, EVAN JONES (MD)
Entity Type:Individual
Prefix:
First Name:EVAN
Middle Name:JONES
Last Name:GRIFFITHS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1321
Mailing Address - Country:US
Mailing Address - Phone:612-262-5000
Mailing Address - Fax:
Practice Address - Street 1:1601 SAINT FRANCIS AVE
Practice Address - Street 2:STE 100
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-3383
Practice Address - Country:US
Practice Address - Phone:952-428-3535
Practice Address - Fax:952-428-3599
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN46734207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN160003415Medicare PIN