Provider Demographics
NPI:1366524076
Name:GRIFFITH, PATRICK D (MD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:D
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PAIN SOURCE SOLUTIONS LLC
Mailing Address - Street 2:PO BOX 7391
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116
Mailing Address - Country:US
Mailing Address - Phone:816-221-5050
Mailing Address - Fax:816-471-1247
Practice Address - Street 1:2800 CLAY EDWARDS DR
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3220
Practice Address - Country:US
Practice Address - Phone:816-221-4114
Practice Address - Fax:816-471-1247
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2009-09-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR4N50207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO206861312Medicaid
E66062Medicare UPIN
MO206861312Medicaid