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General NPI Number Information
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NPI Number | 1356321616
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Entity Type | Individual
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Provider Name | CALVIN F GRAHAM OD
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Gender | Male
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Dates
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Enumeration Date | 01/20/2006
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Last Update Date | 12/06/2011
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Provider Practice Location Address
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Address Line | 1001 LEXINGTON AVE.
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City | FORT SMITH
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State | AR
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Zip | 72901-4945
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Country | US
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Telephone | 479-782-6737
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Fax | 479-782-1071
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Provider Business Mailing Address
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Address Line | 1001 LEXINGTON AVE.
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City | FORT SMITH
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State | AR
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Zip | 72901
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Country | US
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Telephone | 479-782-6737
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Fax | 479-782-1071
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2072
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | AR20723
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | AR2072/OP1100009
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License Number State | AR
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