Individual
BLAKELEY D GRIFFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Mailing address
2757 MOON SHORES DR, KNOXVILLE, TN 37938-4581
(865) 209-9689
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
T-5989
MS
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/09/2025
Last updated
07/01/2025
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