Graham, Jess
Graham, Jess is an individual health care provider with primary practice located at 933 Bradbury Dr Se , Albuquerque NM 87106-4374. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Graham, Jess can be contacted via phone (505) 272-3303.Contact Information
Primary practice address
933 Bradbury Dr Se
Albuquerque NM 87106-4374
Phone: (505) 272-3303
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 25061 | Nebraska |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MD2018-0123 | New Mexico |
Profile Details
| NPI number | 1083604854 |
|---|---|
| LBN Legal business name | Graham, Jess |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 24th, 2005 |
| Last updated | Mar 21st, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083604854 | NPPES |
| New Mexico | MEDICAID | 57178259 |
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