Individual
DAVID L GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
702 W BROADWAY AVE, ENID, OK 73701-3845
(580) 234-4861
(405) 216-0145
Mailing address
307 E DANFORTH AVE, SUITE 154, EDMOND, OK 73034-4487
(405) 216-0100
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
20601
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070016120
RAILROAD MEDICARE
OK
01
—
1284924837
NPI
OK
01
—
1284924837
BLUE CROSS
—
01
—
1912902842
NPI
OK
Enumeration date
06/16/2005
Last updated
09/24/2024
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