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Individual

DR. JOHN ANTHONY GRISWOLD JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3601 4TH ST, LUBBOCK, TX 79430-0002
(806) 743-2373
(806) 743-4354
Mailing address
PO BOX 5865, LUBBOCK, TX 79408-5865
(806) 743-2898
(806) 743-2787

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
G1419
TX
2086S0102X
Surgical Critical Care Physician
Primary
G1419
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100204440A
OK
01
114085100
FIRSTCARE COMMERCIAL
TX
05
114085101
TX
05
125354402
TX
05
125354403
TX
01
201015993
PRESBYTERIAN COMMERCIAL
NM
05
201015993
NM
01
80840Z
HMO BLUE
TX
01
83G204
BC/BS
TX
01
A039
TRIWEST
NM
05
Y0224
NM
Enumeration date
12/02/2005
Last updated
11/23/2021
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