Individual
OCTAVIA LAWTON GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9475 US-19, ZEBULON, GA 30295
(404) 321-6111
Mailing address
5962 ZEBULON RD # 186, MACON, GA 31210-2099
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
008710
GA
207Q00000X
Family Medicine Physician
Primary
59410
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2016
Last updated
01/10/2024
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