Provider Demographics
NPI:1891703880
Name:GRIFFITHS, ALLEN DALE (OD)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:DALE
Last Name:GRIFFITHS
Suffix:
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 1:239 E COURT ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON CH
Mailing Address - State:OH
Mailing Address - Zip Code:43160-1357
Mailing Address - Country:US
Mailing Address - Phone:740-335-2771
Mailing Address - Fax:743-335-2771
Practice Address - Street 1:239 E COURT ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON CH
Practice Address - State:OH
Practice Address - Zip Code:43160-1357
Practice Address - Country:US
Practice Address - Phone:740-335-2771
Practice Address - Fax:743-335-2771
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3122152W00000X
OHT2271152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH410046181OtherRAILROAD MEDICARE
OH0259054Medicaid
OH4316290001Medicare NSC
OH0730662Medicare PIN
OH0259054Medicaid