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General NPI Number Information
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NPI Number | 1225487465
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Entity Type | Individual
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Provider Name | MATTHEW JOHN GRAVES M.D,
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Gender | Male
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Dates
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Enumeration Date | 06/08/2016
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 4 E CLARK BASS BLVD STE 301
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City | MCALESTER
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State | OK
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Zip | 74501-4269
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Country | US
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Telephone | 918-426-2442
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Fax | 918-426-0888
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Provider Business Mailing Address
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Address Line | PO BOX 1992
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City | MCALESTER
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State | OK
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Zip | 74502-1992
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Country | US
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Telephone | 918-426-2442
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Fax | 918-426-0888
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 35488
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License Number State | OK
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