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NPI Code Detail

MEDICARE: DR. GENE S GRAHAM

MEDICARE: DR. GENE S GRAHAM
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
1213E00000XPodiatrist1839OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
231-1062667OTHEROHTAX ID

General Provider Information

NPI Number : 1881697902
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GENE S GRAHAM
Provider Business Mailing Address
First Line : 1871 W WILLIAM ST
Second Line :
City : DELAWARE
State : OH
Zip : 43015-2255
Country : US
Telephone Number : 740-363-4373
Fax Number : 740-363-9560
Provider Business Practice Location Address
First Line : 1871 W WILLIAM ST
Second Line :
City : DELAWARE
State : OH
Zip : 43015-2255
Country : US
Telephone Number : 740-363-4373
Fax Number : 740-363-9560
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 09/10/2015

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Directions to “ DR. GENE S GRAHAM ” Practice Location

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