Provider Demographics
NPI:1497834170
Name:GRIFFITH, SCOTT (PA)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 TOWN SQUARE BLVD
Mailing Address - Street 2:SUITE 218
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-5066
Mailing Address - Country:US
Mailing Address - Phone:828-684-1212
Mailing Address - Fax:828-684-1103
Practice Address - Street 1:30 TOWN SQUARE BLVD
Practice Address - Street 2:SUITE 218
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-5066
Practice Address - Country:US
Practice Address - Phone:828-684-1212
Practice Address - Fax:828-684-1103
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-06305363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA138870JZWMedicare PIN