Provider Demographics
NPI:1881818599
Name:GRIFFITH, SCOTT EDWARD (SA-C)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:EDWARD
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:SA-C
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 1007
Mailing Address - Street 2:334 4TH AVENUE
Mailing Address - City:AFTON
Mailing Address - State:WY
Mailing Address - Zip Code:83110-1007
Mailing Address - Country:US
Mailing Address - Phone:307-248-1355
Mailing Address - Fax:
Practice Address - Street 1:334 4TH AVENUE
Practice Address - Street 2:
Practice Address - City:AFTON
Practice Address - State:WY
Practice Address - Zip Code:83110-1007
Practice Address - Country:US
Practice Address - Phone:307-248-1355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant