Individual
DR. RANDAL OLIVER GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1819 W CLINCH AVE STE 200, KNOXVILLE, TN 37916-2435
(865) 524-3695
(865) 602-3528
Mailing address
PO BOX 52948, KNOXVILLE, TN 37950-2948
(865) 306-5675
(865) 584-7712
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD 17921
TN
2086S0129X
Vascular Surgery Physician
MD17921
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3026054
—
TN
Enumeration date
08/23/2006
Last updated
10/10/2013
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