Provider Demographics
NPI:1285731513
Name:GRIFFITH, JAMES P (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:P
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 MACCORKLE AVE SE STE 205
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1228
Mailing Address - Country:US
Mailing Address - Phone:304-720-7305
Mailing Address - Fax:304-720-7310
Practice Address - Street 1:3100 MACCORKLE AVE SE STE 205
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1228
Practice Address - Country:US
Practice Address - Phone:304-720-7305
Practice Address - Fax:304-720-7310
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV132352084P0800X, 2084P0805X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810002209Medicaid
WV0116149000Medicaid
E96468Medicare UPIN
WV3810002209Medicaid