Provider Demographics
NPI:1972508778
Name:GRIFFITHS, JON DAVID (MD)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:DAVID
Last Name:GRIFFITHS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-3814
Mailing Address - Country:US
Mailing Address - Phone:757-595-0358
Mailing Address - Fax:757-595-6745
Practice Address - Street 1:321 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-3814
Practice Address - Country:US
Practice Address - Phone:757-595-0358
Practice Address - Fax:757-595-6745
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235822208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAI02726Medicare UPIN