Individual
ALECIA ELLEN GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4123 DUTCHMANS LANE, SUITE 507, LOUISVILLE, KY 40207-4730
(502) 423-9595
(502) 719-0161
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
31847
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000724240
ANTHEM - WS
KY
01
—
000057120P
HUMANA - WS
KY
01
—
1052052
PASSPORT
KY
01
—
1166219
GROUP MEDICAID PASSPORT
KY
01
—
127014
SIHO - WS
KY
01
—
5002880
MEDICAID PASSPORT
KY
01
—
50034482
PASSPORT - WS
KY
01
—
5581
MEDICARE GRP
KY
05
—
64318470
—
KY
01
—
65925109
MEDICAID GRP
KY
01
—
8382591
CIGNA-WS
KY
Enumeration date
09/07/2005
Last updated
01/19/2021
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