Basic Information
| Provider Information | |||||||||
| NPI: | 1669815452 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GRIFFITH | ||||||||
| FirstName: | JAMES | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5310 HARVEST HILL RD STE 290 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752305826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2144200650 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11550 GRANADA ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | LEAWOOD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662111453 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9133746711 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2013 | ||||||||
| LastUpdateDate: | 10/17/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ND0101X | 2021042022 | MO | N | Allopathic & Osteopathic Physicians | Dermatology | MOHS-Micrographic Surgery | 207ND0101X | 58926 | TN | N | Allopathic & Osteopathic Physicians | Dermatology | MOHS-Micrographic Surgery | 207ND0101X | 04-45250 | KS | Y | Allopathic & Osteopathic Physicians | Dermatology | MOHS-Micrographic Surgery |
No ID Information.