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Individual

MRS. TREVA JO GRAHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1002 NE HIGHWAY 66, STE 2, SAYRE, OK 73662-9305
(580) 928-2208
(580) 928-2246
Mailing address
1002 NE HIGHWAY 66, STE 2, SAYRE, OK 73662-9305
(580) 928-2208
(580) 928-2246

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21811
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100117500B
OK
Enumeration date
11/02/2006
Last updated
07/10/2012
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