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General NPI Number Information
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NPI Number | 1154540359
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Entity Type | Individual
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Provider Name | EMILY TAYLOR GRAVES M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 11/25/2022
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Provider Practice Location Address
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Address Line | 2606 S. LAMAR
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City | OXFORD
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State | MS
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Zip | 38655-5302
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Country | US
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Telephone | 662-234-6551
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Fax |
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Provider Business Mailing Address
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Address Line | 6363 POPLAR AVE SUITE 101
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City | MEMPHIS
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State | TN
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Zip | 38119-4831
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Country | US
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Telephone | 901-692-5780
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Fax | 901-592-6789
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 23034
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 47117
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License Number State | TN
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