Organization
DOCID1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIM GRIFFIN (PRESIDENT)
(214) 663-8965
Entity
Organization
Contact information
Practice address
1980 TAMARACK RD, NEWARK, OH 43055-1363
(214) 277-3404
Mailing address
4052 W QUAIL HILL CT, BOISE, ID 83703-3856
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
04/10/2016
Last updated
04/10/2016
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