Provider Demographics
NPI:1922265420
Name:GRIFFITH, JOE WESLEY III (AUD)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:WESLEY
Last Name:GRIFFITH
Suffix:III
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9605 JEFFERSON HWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:RIVER RIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70123-2550
Mailing Address - Country:US
Mailing Address - Phone:504-739-7989
Mailing Address - Fax:504-739-7926
Practice Address - Street 1:9605 JEFFERSON HWY
Practice Address - Street 2:SUITE B
Practice Address - City:RIVER RIDGE
Practice Address - State:LA
Practice Address - Zip Code:70123-2550
Practice Address - Country:US
Practice Address - Phone:504-739-7989
Practice Address - Fax:504-739-7926
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80131231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L14635Medicare PIN