DR. JOHN ANTHONY GRISWOLD JR. (NPI# 1720062789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720062789 |
| Entity Type | Individual |
| Full Name | DR. JOHN ANTHONY GRISWOLD JR. |
| Credential | M.D. |
| Practice Address |
3601 4th St Lubbock TX 79430-0002 |
| Mailing Address |
Po Box 5865 Lubbock TX 79408-5865 |
| Practice Telephone | 8067432373 |
| Practice Fax Number | 8067434354 |
| Mailing Telephone | 8067432898 |
| Mailing Fax Number | 8067432787 |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2011-08-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | G1419 | TX | Allopathic & Osteopathic Physicians |
| Y | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
G1419 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 114085101 | 05 | |
| NM | 201015993 | 05 | |
| TX | BC/BS | 83G204 | 01 |
| TX | 125354402 | 05 | |
| TX | FIRSTCARE COMMERCIAL | 114085100 | 01 |
| TX | HMO BLUE | 80840Z | 01 |
| TX | 125354403 | 05 | |
| NM | Y0224 | 05 | |
| OK | 100204440A | 05 | |
| NM | PRESBYTERIAN COMMERCIAL | 201015993 | 01 |
| NM | TRIWEST | A039 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407120199 | John Matt Griswold | Chiropractor | 1322 E 15th St, Tulsa, OK 74120-5804 | 2012-02-28 |
| 1720045941 | John J Griswold | Urology | 295 Essjay Rd, Williamsville, NY 14221-8216 | 2006-05-01 |
| Street Address |
3601 4TH ST |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79430-0002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073516993 | Viviane Mamlok | Pathology | 3601 4th St, 1a115, Lubbock, TX 79430-0002 | 2005-05-24 |
| 1104436252 | Kanak N/a Parmar | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-08-04 |
| 1407465115 | Donald Wayne King Jr. | Nurse Anesthetist, Certified Registered | 3601 4th St, Lubbock, TX 79430-0002 | 2020-07-28 |
| 1588288674 | Hillary Powers | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-06-03 |
| 1215551692 | Amanda R Edinger | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-06-02 |
| 1487278966 | Daniel Elling Brown | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-6211 | 2020-06-01 |
| 1588288013 | Fabiana Monte Alegre Olmos Fernandez | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-06-01 |
| 1154945574 | Alex Wilkins | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-06-01 |
| 1720602253 | Amanda Lee Huggett | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-06-01 |
| 1609490192 | Zeyad Saeed Amr Elharabi | Student in an Organized Health Care Education/Training Program | 3601 4th St, Department of Internal Medicine, Lubbock, TX 79430-0002 | 2020-06-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730702473 | Emily Bouffard | Student in an Organized Health Care Education/Training Program | 3601 4th Street Mail Stop 8143, Lubbock, TX 79430 | 2020-05-27 |
| 1891350310 | Erin Leigh Burton | Student in an Organized Health Care Education/Training Program | 3601 Fourth Street, Department of Surgery Ms 8312, Lubbock, TX 79430 | 2019-05-09 |
| 1851861439 | Zachery Brian Sneed | Counselor | 3b310, 3601 4th St Stop 6225, Lubbock, TX 79430 | 2018-11-27 |
| 1831683481 | Swagat Parajulee | Student in an Organized Health Care Education/Training Program | 3601 4th St., Stop 9410, Office 4b076, Lubbock, TX 79430 | 2018-06-18 |
| 1649711904 | William David Boothe Jr. | Dermatology | 3601 4th St Stop 6211, Lubbock, TX 79430 | 2017-03-19 |
| 1982144945 | Kazutaka Araki | Specialist/Technologist | 3601, 4th St, Lubbock, TX 79430 | 2017-02-24 |
| 1659725125 | Thomas Gregory Wyatt | Student in an Organized Health Care Education/Training Program | 3601 4th St Rm 3a122b, Lubbock, TX 79430 | 2016-04-20 |
| 1619391760 | Chinyere Mbagwu | General Practice | 3601 4th St # Ms 8143, Lubbock, TX 79430 | 2014-02-10 |
| 1982044111 | Eileen Mary Sprys | Family Medicine | 3601 4th St., Stop 8143, Lubbock, TX 79430 | 2013-07-02 |
| 1205196243 | Hilmi Alam | Family Medicine | Department of Family & Community Medicine, 3601 4th Street, Stop 8143, Lubbock, TX 79430 | 2012-05-24 |
| Find all providers in zip 79430 | ||||
| Taxonomy Code | 2086S0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Critical Care |
| A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730418898 | Clarisse Djukom | Surgery | 3102 69th St, Galveston, TX 77551-2191 | 2009-12-18 |
| 1851528335 | Erich Paul Gerhardt | Surgery | 910 E Houston St Ste 530, Tyler, TX 75702-8366 | 2009-06-11 |
| 1588752380 | Octavio Javier Garcia Sr. | Surgery | 822 Kinney St, Corpus Christi, TX 78401-3006 | 2006-10-10 |
| 1154355626 | David Lawrence Smith | Surgery | 4001 W 15th St Ste 425, Plano, TX 75093-5848 | 2006-07-10 |
| 1932149010 | James Gordon Cushman | Surgery | 18101 Point Lookout Dr Apt 103, Houston, TX 77058-3568 | 2006-06-07 |
| 1710977525 | Lorne Howar Blackbourne | Surgery | 2300 Round Rock Ave Ste 201, Round Rock, TX 78681-4026 | 2005-10-24 |
| 1811997059 | Scott H Norwood | Surgery | 1020 E Idel St, Tyler, TX 75701-2024 | 2005-07-29 |
| 1124438072 | Nestor Arita | Surgery | 1 Baylor Plz, 404d, Houston, TX 77030-3411 | 2014-04-30 |
| 1871837377 | William Benedict Norbury | Surgery | 815 Market St, Shriners Hospitals for Children - Galveston, Galveston, TX 77550-2725 | 2012-11-21 |
| 1932469178 | Anthony Cahill | Surgery | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2012-05-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.