Graham, Randal Oliver

Graham, Randal Oliver is an individual health care provider with primary practice located at 1819 W Clinch Ave Ste 200 , Knoxville TN 37916-2435. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Graham, Randal Oliver can be contacted via phone (865) 524-3695.

Contact Information

Primary practice address
1819 W Clinch Ave Ste 200 Knoxville TN 37916-2435
Phone: (865) 524-3695
Fax: (865) 602-3528
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD 17921 Tennessee
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X MD17921 Tennessee

Profile Details

NPI number 1710094180
LBN Legal business name Graham, Randal Oliver
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2006
Last updated Oct 10th, 2013 - about 13 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 1710094180 NPPES
Tennessee MEDICAID 3026054

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