Provider Demographics
NPI:1790998789
Name:GRIFFIN, DAVID C JR (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:GRIFFIN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5169 S COTTONWOOD ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-6767
Mailing Address - Country:US
Mailing Address - Phone:801-507-3600
Mailing Address - Fax:801-507-3625
Practice Address - Street 1:5169 S COTTONWOOD ST
Practice Address - Street 2:SUITE 600
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-6767
Practice Address - Country:US
Practice Address - Phone:801-507-3600
Practice Address - Fax:801-507-3625
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT6359024-1205208600000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery