Individual
TRACY WARWICK GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
706 MAIN ST STE 2A, KLAMATH FALLS, OR 97601-6010
(541) 851-7350
(541) 851-7351
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
(605) 328-6512
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
23546
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286410
—
OR
05
—
XPY197937
—
CA
Enumeration date
11/03/2006
Last updated
08/25/2022
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