# GRAHAM EAR, NOSE & THROAT P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063647154
- **Authorized official:** WILLIAM NOBLE GRAHAM D.O. (OWNER)
- **Authorized official phone:** (605) 996-8386

## Contact information

- **Practice address:** 625 N FOSTER ST STE 203, MITCHELL, SD 57301-2969
- **Practice address phone:** (605) 996-8386
- **Practice address fax:** (605) 996-9153
- **Mailing address:** 625 N FOSTER ST STE 203, MITCHELL, SD 57301-2969
- **Mailing address phone:** (605) 996-8386
- **Mailing address fax:** (605) 996-9153

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YS0123X | Facial Plastic Surgery Physician | 4248 | SD | Yes |

## Other

- **Enumeration date:** 05/19/2009
- **Last updated:** 05/19/2009

## 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 |