Organization
PHILIP R GRAHAM & WILLIAM J
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP R GRAHAM O D (OWNER)
(662) 489-4741
Entity
Organization
Contact information
Practice address
14 E MARION ST, PONTOTOC, MS 38863-2813
(662) 489-4741
(662) 489-2940
Mailing address
PO BOX 120, PONTOTOC, MS 38863-0120
(662) 489-4741
(662) 489-2940
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
02/18/2009
Last updated
02/18/2009
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