Provider Demographics
NPI:1669441820
Name:GRIGGS, DAVID DANIEL (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:DANIEL
Last Name:GRIGGS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 US HIGHWAY 72 W
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35611-4211
Mailing Address - Country:US
Mailing Address - Phone:256-232-7011
Mailing Address - Fax:256-232-4311
Practice Address - Street 1:619 US HIGHWAY 72 W
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-4211
Practice Address - Country:US
Practice Address - Phone:256-232-7011
Practice Address - Fax:256-232-4311
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-966-TA-523152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALAL 0523OtherEYEMED/COLE
AL515-16728OtherBLUE CROSS BLUE SHIELD
AL515-16728OtherBLUE CROSS BLUE SHIELD