Individual
DR. STEVEN DONALD GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3336 N FUTRALL DRIVE, FAYETTEVILLE, AR 72703
(479) 463-3000
(479) 463-3050
Mailing address
PO BOX 550, LOWELL, AR 72745-0550
(479) 463-7775
(479) 463-7187
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
E-13761
AR
174400000X
Specialist
MD0000019275
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3845929
—
TN
01
—
4062895
BLUE CROSS BLUE SHIELD
TN
Enumeration date
01/06/2006
Last updated
01/19/2021
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