Individual
LEPERCIVAL GRIFFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1860 CHADWICK DR STE 351, JACKSON, MS 39204-3472
(601) 376-1288
(601) 376-1293
Mailing address
PO BOX 321359, FLOWOOD, MS 39232-1359
(601) 936-1395
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22553
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07754391
—
MS
Enumeration date
04/30/2010
Last updated
09/13/2022
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