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Individual

MARK GRIFFIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
111 NORTH 3RD ST, GLENWOOD, GA 30428-9004
(912) 523-5113
(912) 523-2049
Mailing address
111 N 3RD ST, GLENWOOD, GA 30428-9004
(912) 523-5113
(912) 523-2049

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38140
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00569676D
GA
Enumeration date
10/20/2005
Last updated
12/30/2011
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