# CARL N. GRIFFIN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1548365117
- **Gender:** Man
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | 3095 | OK | — |
| 207Q00000X | Family Medicine Physician | 03095 | OK | Yes |

## Other

- **Enumeration date:** 09/14/2006
- **Last updated:** 10/20/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200102570A | — | OK |
| 01 | — | 73-0804209 | TAX ID | OK |
| 01 | — | 730804209001 | BC GROUP NUMBER | OK |