Individual
DR. WILLIAM S GRAHAM JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 W COLLEGE ST STE 120, SPRINGFIELD, MO 65806-1201
(417) 831-0022
(417) 831-0451
Mailing address
600 W COLLEGE ST STE 120, SPRINGFIELD, MO 65806-1201
(417) 831-0022
(417) 831-0451
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
114654
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116495
MO BLUE SHIELD
MO
05
—
203756101
—
MO
01
—
83834
ARK BLUE SHIELD
AR
Enumeration date
02/07/2007
Last updated
10/17/2012
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