Individual
STEPHEN C. GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
EAST MAIN & SOUTH 20TH STREET, VAN BUREN, AR 72957
(479) 474-3401
(479) 471-4388
Mailing address
18167 US HIGHWAY 19 N, SUITE 650, CLEARWATER, FL 33764-3528
(800) 507-8874
(727) 536-2896
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
R-2330
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105519001
—
AR
01
—
51972
BLUECROSS BLUESHIELD
AR
Enumeration date
01/12/2006
Last updated
04/20/2011
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