Healthcare Provider Details

I. General information

NPI: 1184042020
Provider Name (Legal Business Name): ALEXANDER GRAF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2014
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 JENNINGS MILL RD BLDG 300-110
WATKINSVILLE GA
30677-7238
US

IV. Provider business mailing address

1305 JENNINGS MILL RD BLDG 300-110
WATKINSVILLE GA
30677-7238
US

V. Phone/Fax

Practice location:
  • Phone: 706-613-5880
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number64384
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number64384
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: