Provider Demographics
NPI:1841748308
Name:SCOTT GRIFFITH, M.D. P.C.
Entity Type:Organization
Organization Name:SCOTT GRIFFITH, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:D
Authorized Official - Last Name:GRIFFITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-234-2332
Mailing Address - Street 1:4310 JOHNS CREEK PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6092
Mailing Address - Country:US
Mailing Address - Phone:678-234-2332
Mailing Address - Fax:
Practice Address - Street 1:120 KESWICK WAY
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30022-6315
Practice Address - Country:US
Practice Address - Phone:770-410-1186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-13
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA36386207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0051828BMedicaid
GA0051828BMedicaid
GA08BDNBWMedicare Oscar/Certification