Individual
LARRY PAUL GRIFFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4130 DUTCHMANS LN, STE 400, LOUISVILLE, KY 40207-4711
(502) 897-0697
(502) 897-0658
Mailing address
PO BOX 950202, LOUISVILLE, KY 40295-0202
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
01035329A
IN
207VM0101X
Maternal & Fetal Medicine Physician
Primary
17396
KY
207VM0101X
Maternal & Fetal Medicine Physician
MD21040
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0700557
UNITED HEALTHCARE
KY
01
—
1097322
PASSPORT
KY
01
—
2112000000044474
BLUE CROSS/BLUE SHIELD
KY
01
—
2258716
AETNA
KY
01
—
50036611
PASSPORT - WS
KY
01
—
610673930S
HUMANA
KY
05
—
64173966
—
KY
Enumeration date
06/15/2005
Last updated
10/24/2012
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