Eugene Wilson Griffin III, M.D.
Individual provider Active NPI Family Medicine Physician · Jonesville, NC
NPI 1871609263 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1871609263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 23845 (NC)
- Practice address
- 4000 S Swaim Street Ext
Jonesville, NC 28642-9418 - Phone
- (336) 835-6300
- Fax
- (336) 835-4761
- NPI assigned
- Aug 21, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100811000148 | NC | Practitioner - Family Practice |
3072407303 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cornerstone Health Care PA | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 23845 | NC | Yes |
Addresses
Primary practice location
4000 S Swaim Street Ext
Jonesville, NC 28642-9418
Mailing address
4000 S Swaim Street Ext
Jonesville, NC 28642-9418
Phone (336) 835-6300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2483 | Other | NC | PARTNERS |
| 34629 | Other | NC | MEDCOST |
| 37238 | Other | NC | BCBSNC |
| 4254794 | Other | NC | AETNA |
| 8937238 | Medicaid | NC |
Other providers in Jonesville, NC
- D-Rex Drugs of Jonesville, Inc.
- Envisions of Life LLC
- Rebekah Ann Garris
- Gaston Family Health Services, Inc.
- Tonya Geddes
- Christopher W Groner
- Mary McEvilly Hedrick
- Deborah T. Hemric
- Hope Recovery Services Inc
- James E Hubbs
All providers in Jonesville, NC · Family Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.