Provider Demographics
NPI:1821080953
Name:GRIFFIS, WILLIAM S (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:S
Last Name:GRIFFIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 973403
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75397-3403
Mailing Address - Country:US
Mailing Address - Phone:719-634-5340
Mailing Address - Fax:719-634-5517
Practice Address - Street 1:2162 HOLLOW BROOK DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-1444
Practice Address - Country:US
Practice Address - Phone:719-634-5340
Practice Address - Fax:719-634-5517
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO30648208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
COF18953Medicare UPIN
CO0412-2Medicare ID - Type Unspecified