Provider Demographics
NPI:1467538777
Name:GRIFFIN, SCOTT BURTON (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:BURTON
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 1:55 E 700 S
Mailing Address - Street 2:#41
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-3961
Mailing Address - Country:US
Mailing Address - Phone:435-673-2234
Mailing Address - Fax:
Practice Address - Street 1:55 E 700 S
Practice Address - Street 2:#41
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-3961
Practice Address - Country:US
Practice Address - Phone:435-673-2234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-29
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT172693-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT107000744101OtherSELECTHEALTH PROVIDER
UT36521OtherDMBA
UT000005815Medicare ID - Type UnspecifiedMEDCARE PROVIDER