Provider Demographics
NPI:1740254440
Name:GRIFFIN, JOHN JOSEPH JR (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JOSEPH
Last Name:GRIFFIN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7068
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-0068
Mailing Address - Country:US
Mailing Address - Phone:757-686-3508
Mailing Address - Fax:757-686-0541
Practice Address - Street 1:1708 OLD DONATION PKWY
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3064
Practice Address - Country:US
Practice Address - Phone:757-395-5300
Practice Address - Fax:757-213-9341
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101039856207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA-001OtherCHAMPUS/TRICARE
VA15739OtherOPTIMA/SENTARA
NC0572BOtherBC/BS NC
VA006096182Medicaid
NC890572BMedicaid
VAPAROtherFIRST HEALTH
VA428974OtherUHC/MAMSI/MDIPA
VAPAROtherVHN/P HCS
VAPAROtherVIRGINIA PREMIER HEALTH
NC0572BOtherBCBS
VA453601OtherANTHEM BC/BS
VAPAROtherAETNA PPO
VAPAROtherCORVEL/CORCARE
VAPAROtherCIGNA
VA006055532Medicaid
VA40315OtherSENTARA OHP/SHP
VAPAROtherUSA MANAGED CARE
VA285856OtherANTHEM BCBS
VAPAROtherMULTIPLAN
VA006055532Medicaid
VAPAROtherVHN/P HCS
VA453601OtherANTHEM BC/BS
VAPAROtherCORVEL/CORCARE