Individual
DR. CHARLES R. GRIFFITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1560 SUMRALL RD, COLUMBIA, MS 39429-2654
(601) 261-2940
(601) 261-2942
Mailing address
PO BOX 630, COLUMBIA, MS 39429-0630
(601) 261-2940
(601) 261-2942
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17786
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126499
—
MS
01
—
7074524
AETNA
MS
Enumeration date
04/18/2006
Last updated
12/07/2015
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