Individual
GRAHAM GROGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5100
Mailing address
110 CHADWYCK CT, MADISON, MS 39110-6506
(601) 717-3695
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
T-5351
MS
Other
Enumeration date
03/26/2024
Last updated
07/09/2024
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