Provider Demographics
NPI:1790783181
Name:GRIFFITH, FLOYD L JR (OD)
Entity Type:Individual
Prefix:DR
First Name:FLOYD
Middle Name:L
Last Name:GRIFFITH
Suffix:JR
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 1:853 IRVINGTON RD
Mailing Address - Street 2:
Mailing Address - City:WEEMS
Mailing Address - State:VA
Mailing Address - Zip Code:22576-2218
Mailing Address - Country:US
Mailing Address - Phone:804-435-2616
Mailing Address - Fax:804-436-0181
Practice Address - Street 1:853 IRVINGTON RD
Practice Address - Street 2:
Practice Address - City:WEEMS
Practice Address - State:VA
Practice Address - Zip Code:22576-2218
Practice Address - Country:US
Practice Address - Phone:804-435-2616
Practice Address - Fax:804-436-0181
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000058152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10414785OtherCAQH
VA9204997Medicaid
VAT89083Medicare UPIN
VACO1187Medicare PIN
VA410000340Medicare ID - Type Unspecified