Individual
GARY E GRIFFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1212 S DOUGLAS BLVD, SUITE B, OKLAHOMA CITY, OK 73130-5259
(405) 736-6811
(405) 736-6863
Mailing address
1122 NE 13TH ST, ORI 236, OKLAHOMA CITY, OK 73117-1039
(405) 736-6811
(405) 736-6863
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
3822
OK
207Q00000X
Family Medicine Physician
Primary
E1832
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100091670A
—
OK
05
—
134702003
—
AR
Enumeration date
09/26/2005
Last updated
09/20/2012
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