Individual
CARL N. GRIFFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6908 E RENO AVE, MIDWEST CITY, OK 73110-2128
(405) 737-7000
(405) 737-7700
Mailing address
PO BOX 269064, OKLAHOMA CITY, OK 73126-9064
(405) 231-3857
(405) 272-7977
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
3095
OK
207Q00000X
Family Medicine Physician
Primary
03095
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200102570A
—
OK
01
—
73-0804209
TAX ID
OK
01
—
730804209001
BC GROUP NUMBER
OK
Enumeration date
09/14/2006
Last updated
10/20/2014
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