Provider Demographics
NPI:1740752906
Name:ROBERT CARL GRIFFITH MD
Entity Type:Organization
Organization Name:ROBERT CARL GRIFFITH MD
Other - Org Name:ROBERT C. GRIFFITH, III, MD, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:KEALLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-416-6438
Mailing Address - Street 1:6311 KINGSTON PIKE STE 22E
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-4900
Mailing Address - Country:US
Mailing Address - Phone:865-588-1361
Mailing Address - Fax:
Practice Address - Street 1:6311 KINGSTON PIKE STE 22E
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-4900
Practice Address - Country:US
Practice Address - Phone:865-588-1361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-27
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center