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Individual

DR. JEFFREY T GRIFFIN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
2753 S CLARK, MEXICO, MO 65265
(573) 581-8668
(573) 581-8850
Mailing address
12058 ACR 945, THOMPSON, MO 65285
(573) 581-8668
(573) 581-8850

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02726
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
119720
BLUE CROSS BLUE SHIELD
MO
01
2353632
UNITED HEALTH CARE
01
54059
HEALTHCARE USA
MO
Enumeration date
11/10/2005
Last updated
07/08/2007
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