Provider Demographics
NPI:1023471901
Name:GRIFFIN, DAVID R (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 30015 DPT 93
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84130-0015
Mailing Address - Country:US
Mailing Address - Phone:801-476-0494
Mailing Address - Fax:801-479-3937
Practice Address - Street 1:1972 W GROVE PKWY
Practice Address - Street 2:STE 300
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062-8406
Practice Address - Country:US
Practice Address - Phone:801-476-0494
Practice Address - Fax:801-221-1052
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2020-06-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK32749207W00000X
UT11713637-1205207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology