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Individual

DR. JESS GRAHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
933 BRADBURY DR SE, ALBUQUERQUE, NM 87106-4374
(505) 272-3303
Mailing address
933 BRADBURY DR SE, ALBUQUERQUE, NM 87106-4374
(505) 272-3303

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
25061
NE
2085R0202X
Diagnostic Radiology Physician
Primary
MD2018-0123
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
57178259
NM
Enumeration date
10/24/2005
Last updated
03/21/2018
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