Individual
DR. STEPHEN J. GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9983 E DESERT TRAIL LN, GOLD CANYON, AZ 85118-4922
(406) 425-1355
(801) 618-4185
Mailing address
9983 E DESERT TRAIL LN, GOLD CANYON, AZ 85118-4922
(064) 251-3554
(801) 618-4185
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
184400-1205
UT
207W00000X
Ophthalmology Physician
19987
AZ
208D00000X
General Practice Physician
Primary
184400-1205
UT
208D00000X
General Practice Physician
19987
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
508021
—
AZ
Enumeration date
08/26/2005
Last updated
07/13/2021
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