Provider Demographics
NPI:1437199056
Name:GRIFFITH, BRIAN K (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:K
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:501 SUMMERS ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-1239
Mailing Address - Country:US
Mailing Address - Phone:304-343-3937
Mailing Address - Fax:304-344-3957
Practice Address - Street 1:4522 MACCORKLE AVE SE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1840
Practice Address - Country:US
Practice Address - Phone:304-982-8246
Practice Address - Fax:304-345-1801
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WVWV21067207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV2004585000Medicaid
WVI83569Medicare UPIN
WV4106082Medicare PIN
WV2004585000Medicaid
WV4106081Medicare PIN