Individual
DR. GORDON KEITH GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
212 S BLISS AVE, DUMAS, TX 79029-3806
(806) 934-4979
(806) 934-4984
Mailing address
PO BOX 394, DUMAS, TX 79029-0394
(806) 934-4979
(806) 934-4984
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
L3888
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024116
FIRSTCARE
TX
05
—
154266403
—
TX
01
—
8G5571
BCBS
TX
01
—
TXB161287
MEDICARE
TX
Enumeration date
08/18/2006
Last updated
03/02/2020
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