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Individual

REBECCA GRAHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O

Contact information

Practice address
3300 HEALTHPLEX PKWY, NORMAN, OK 73072
(405) 515-6615
(405) 515-3635
Mailing address
3117 TERRACE PARK TRL, NORMAN, OK 73069-7585
(816) 805-1993

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
103674
MO
207V00000X
Obstetrics & Gynecology Physician
528059
KS
207V00000X
Obstetrics & Gynecology Physician
Primary
5743
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100330060D
KS
01
1245211846
TRICARE
01
2089570
UNITED HEALTH CARE
01
29241057
BCBS
01
5135654
AETNA
01
9181474
CIGNA
Enumeration date
11/10/2005
Last updated
11/09/2018
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