Doctor Name: | DR. DONALD GRAHAM |
NPI Number: | 1639287949 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O. |
License Number: | 057629 |
Business Practice Address: | 1211 Merchants Way Suite 401 Statesboro, GA - 304580867 |
Business Phone Number: | 9128717777 |
Business Fax Number: | 9128717172 |
Mailing Address: | 1211 Merchants Way, Suite 401 STATESBORO |
State: | GA |
Postal Code: | 304580867 |
Phone Number: | 9128717777 |
Fax Number: | 9128717172 |
NPI Enumeration Date: | 08/27/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 057629 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |