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Individual

DR. REGINALD LANE GRIFFIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1630 SE 18TH ST STE 103, OCALA, FL 34471-5409
(352) 236-5809
Mailing address
1630 SE 18TH ST STE 103, OCALA, FL 34471-5409
(352) 236-5809

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME112612
FL
208600000X
Surgery Physician
TRN11572
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
022503400
FL
Enumeration date
06/07/2007
Last updated
04/17/2019
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