Provider Demographics
NPI:1265440069
Name:BROOKS GRIFFIN, MD, PLLC
Entity type:Organization
Organization Name:BROOKS GRIFFIN, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:BROOKS
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-932-7005
Mailing Address - Street 1:1020 RIVER OAKS DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9500
Mailing Address - Country:US
Mailing Address - Phone:601-932-7005
Mailing Address - Fax:601-932-7156
Practice Address - Street 1:1020 RIVER OAKS DR
Practice Address - Street 2:SUITE 110
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9500
Practice Address - Country:US
Practice Address - Phone:601-932-7005
Practice Address - Fax:601-932-7156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty