Individual
DR. MARCIA K GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3231 S NATIONAL AVE, SUITE 280, SPRINGFIELD, MO 65807-7304
(417) 885-0834
(417) 888-6763
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
114945
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138416
MO BLUE SHIELD
MO
05
—
203756002
—
MO
01
—
83136
ARK BLUE SHIELD
AR
Enumeration date
02/07/2007
Last updated
07/14/2008
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