MEDICARE: GARTH P GRAHAM MD

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
1	2085R0202X	Diagnostic Radiology Physician	37249	TN
2	2085B0100X	Body Imaging Physician	MD37249	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790765378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARTH P GRAHAM MD

Provider Business Mailing Address
First Line	:	2001 LAUREL AVE
Second Line	:	SUITE N304
City	:	KNOXVILLE
State	:	TN
Zip	:	37916-1810
Country	:	US
Telephone Number	:	865-546-9484
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 LAUREL AVE
Second Line	:	SUITE N304
City	:	KNOXVILLE
State	:	TN
Zip	:	37916-1810
Country	:	US
Telephone Number	:	865-546-9484
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	04/08/2026

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