Organization
B. TODD GRAYBILL, PH.D., P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. B. TODD GRAYBILL PH.D. (MEMBER)
(918) 683-8827
Entity
Organization
Contact information
Practice address
333 S 38TH ST, SUITE K, MUSKOGEE, OK 74401-4937
(918) 683-8827
(918) 686-0902
Mailing address
333 S 38TH ST, SUITE K, MUSKOGEE, OK 74401-4937
(918) 683-8827
(918) 686-0902
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
353
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
443-48-2619-002
BLUE CROSS BLUE SHIELD
OK
Enumeration date
08/11/2006
Last updated
08/22/2020
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