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Organization
GRAHAM EAR, NOSE & THROAT P.C.
Active
Organization
GRAHAM EAR, NOSE & THROAT P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM NOBLE GRAHAM D.O. (OWNER)
(605) 996-8386
Entity
Organization
Contact information
Practice address
625 N FOSTER ST STE 203, MITCHELL, SD 57301-2969
(605) 996-8386
(605) 996-9153
Mailing address
625 N FOSTER ST STE 203, MITCHELL, SD 57301-2969
(605) 996-8386
(605) 996-9153
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
4248
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005047
BLUE CROSS BLUE SHILED
SD
01
—
20223
SANFORD HEALTH
SD
01
—
2070
AVERA HEALTH
SD
05
—
6520252
—
SD
Enumeration date
05/19/2009
Last updated
05/19/2009
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