Organization
GRAHAM DERMATOLOGY CENTER, P.C.
Active
Organization
GRAHAM DERMATOLOGY CENTER, P.C.
Active
Other names
Silver Leaf Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID L GRAHAM M.D. (OWNER)
(405) 216-0100
Entity
Organization
Contact information
Practice address
307 E DANFORTH RD, SUITE 154, EDMOND, OK 73034-4483
(405) 216-0100
Mailing address
307 E DANFORTH RD, SUITE 154, EDMOND, OK 73034-4483
(405) 216-0100
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
20601
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912902842
NPI
OK
Enumeration date
04/17/2011
Last updated
08/19/2016
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