Provider Demographics
NPI:1790765527
Name:GRIFFIN, FRANKIE M (MD)
Entity Type:Individual
Prefix:
First Name:FRANKIE
Middle Name:M
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 405981
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-5981
Mailing Address - Country:US
Mailing Address - Phone:479-709-7399
Mailing Address - Fax:479-709-7053
Practice Address - Street 1:2020 CHESTNUT ST
Practice Address - Street 2:STE 107
Practice Address - City:VAN BUREN
Practice Address - State:AR
Practice Address - Zip Code:72956-5321
Practice Address - Country:US
Practice Address - Phone:479-474-8005
Practice Address - Fax:479-474-4773
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC-8118174400000X
ARC8118207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR134164002Medicaid
ARG56873Medicare UPIN
AR5K553Medicare ID - Type Unspecified