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NPI Code Detail

MEDICARE: JAMES MICHAEL GRAHAM M.D.

MEDICARE: JAMES MICHAEL GRAHAM M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician22664KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10700049OTHERKYUNITED HEALTHCARE
250036612OTHERKYPASSPORT - WS
3160032459OTHERKYRAILROAD
4610673930AOTHERKYHUMANA
51519000000044478OTHERKYBLUE CROSS/BLUE SHIELD
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356346167
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES MICHAEL GRAHAM M.D.
Provider Business Mailing Address
First Line : PO BOX 776351
Second Line :
City : CHICAGO
State : IL
Zip : 60677-6635
Country : US
Telephone Number : 502-588-9490
Fax Number : 502-272-5116
Provider Business Practice Location Address
First Line : 4130 DUTCHMANS LN
Second Line : STE 400
City : LOUISVILLE
State : KY
Zip : 40207-4711
Country : US
Telephone Number : 502-897-0697
Fax Number : 502-897-0658
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2005
Last Update Date : 01/12/2021

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