Individual
ALAN DARYL GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 CITY HILL DR, LONDON, KY 40741-3038
(606) 878-6633
(606) 878-5883
Mailing address
PO BOX 1067, LONDON, KY 40743-1067
(606) 878-6633
(606) 878-5883
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
24150
KY
363AS0400X
Surgical Physician Assistant
PA249
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64241508
—
KY
Enumeration date
08/31/2006
Last updated
11/16/2011
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