Graham, Bobby L
Graham, Bobby L is an individual health care provider with primary practice located at 2969 Curran Dr N Ste 200, Jackson MS 39216-4121. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine, Allopathic & Osteopathic Physicians / Medical Oncology. Allopathic & Osteopathic Physicians / Medical Oncology is his primary health care specialty. Graham, Bobby L can be contacted via phone (601) 974-5600.Contact Information
Primary practice address
2969 Curran Dr N Ste 200
Jackson MS 39216-4121
Phone: (601) 974-5600
Fax: (601) 974-5699
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine | 207RH0002X | 10277 | Mississippi |
| Allopathic & Osteopathic Physicians / Medical Oncology | 207RX0202X | 10277 | Mississippi |
Profile Details
| NPI number | 1205831666 |
|---|---|
| LBN Legal business name | Graham, Bobby L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 14th, 2005 |
| Last updated | Dec 8th, 2022 - about 2 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 | 1205831666 | NPPES |
| Other | 4225962 | AETNA HEALTHCARE | |
| MEDICAID | 000115226 | AETNA HEALTHCARE |
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