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Individual

GARY F GRAHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
210 W 300 N, ROOSEVELT, UT 84066-2336
(435) 722-6130
Mailing address
210 W 300 N, ROOSEVELT, UT 84066-2336
(435) 722-6130

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
343506-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1811910359
UT
Enumeration date
07/25/2006
Last updated
05/11/2017
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