Graham, Larry G

Graham, Larry G is an individual health care provider with primary practice located at 5301 Virginia Way Ste 300 , Brentwood TN 37027-7542. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Graham, Larry G can be contacted via phone (615) 221-4474.

Contact Information

Primary practice address
5301 Virginia Way Ste 300 Brentwood TN 37027-7542
Phone: (615) 221-4474
Fax: (615) 234-3774
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 9225 Tennessee
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 24891 Kentucky

Profile Details

NPI number 1871694828
LBN Legal business name Graham, Larry G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Jul 9th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871694828 NPPES
North Carolina MEDICAID 89063F6
North Carolina MEDICAID 3040511
North Carolina MEDICAID 64777063
North Carolina Other 000005006002
North Carolina Other 119586
North Carolina Other 3025074
North Carolina Other 231705

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