Individual
DR. JACOB MARTIN GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6051 U S HIGHWAY 49, HATTIESBURG, MS 39401-7200
(601) 288-7000
Mailing address
PO BOX 607, LAUREL, MS 39441-0607
(601) 518-7054
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
23826
MS
207RH0003X
Hematology & Oncology Physician
Primary
23826
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23826
MEDICAL LICENSURE
MS
01
—
MD.33105
MEDICAL LICENSURE COMMISSION OF ALABAMA
AL
Enumeration date
07/05/2011
Last updated
06/05/2024
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