Provider Demographics
NPI:1467642777
Name:GRIFFIN, JOSEPH MARTIN (MD)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:MARTIN
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8888 SUMMA AVE
Mailing Address - Street 2:CARDIOLOGY TOWER 3RD FLOOR
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3720
Mailing Address - Country:US
Mailing Address - Phone:225-769-4493
Mailing Address - Fax:
Practice Address - Street 1:8888 SUMMA AVE
Practice Address - Street 2:CARDIOLOGY TOWER 3RD FLOOR
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3720
Practice Address - Country:US
Practice Address - Phone:225-769-4493
Practice Address - Fax:225-766-3144
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.200409208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA05517Medicaid