Individual
DR. JACK GRIFFETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715
(770) 219-1824
(770) 219-7787
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
027819
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00602621A
—
GA
Enumeration date
08/10/2005
Last updated
01/26/2021
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