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Individual

DR. IAN R GRAHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
HENRY COUNTY MEDICAL CENTER, 301 TYSON AVENUE, PARIS, TN 38424
(731) 644-8535
(731) 642-9588
Mailing address
PO BOX 2153 DEPT 30755, BIRMINGHAM, AL 35287-9283
(314) 238-5260
(314) 821-1833

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036107429
IL
2085R0202X
Diagnostic Radiology Physician
Primary
2002015742
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
205942303
MO
01
300133434
RAILROAD MEDICARE NUMBER
Enumeration date
07/14/2006
Last updated
10/29/2020
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