Provider Demographics
NPI:1861286197
Name:CHATTERLEY, GRIFFIN (DO)
Entity type:Individual
Prefix:
First Name:GRIFFIN
Middle Name:
Last Name:CHATTERLEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2951 S FITZROY PL APT 105
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-3042
Mailing Address - Country:US
Mailing Address - Phone:425-985-8903
Mailing Address - Fax:
Practice Address - Street 1:1125 N COLLEGE AVE # SLOT100
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-1908
Practice Address - Country:US
Practice Address - Phone:479-713-8310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program