Griffin, James Wallace

Griffin, James Wallace is an individual health care provider with primary practice located at 404 Main Street , New Augusta MS 39462-0349. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Griffin, James Wallace can be contacted via phone (601) 964-8391.

Contact Information

Primary practice address
404 Main Street New Augusta MS 39462-0349
Phone: (601) 964-8391
Fax: (601) 964-8393
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 19990 Mississippi

Profile Details

NPI number 1720274327
LBN Legal business name Griffin, James Wallace
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 18th, 2007
Last updated Jan 17th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720274327 NPPES
Mississippi Other 11803908 CAQH ID NUMBER
Mississippi Other 9493388P02 CAQH ID NUMBER
Mississippi MEDICAID 03300361 CAQH ID NUMBER
Mississippi Other 9982123 CAQH ID NUMBER
Mississippi Other NEW AUGUSTA -1149002 CAQH ID NUMBER

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