Graham, Jack Gregory

Graham, Jack Gregory is an individual health care provider with primary practice located at 8501 Harcourt Rd , Indianapolis IN 46260-2046. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hand Surgery, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Graham, Jack Gregory can be contacted via phone (317) 875-9105.

Contact Information

Primary practice address
8501 Harcourt Rd Indianapolis IN 46260-2046
Phone: (317) 875-9105
Fax: (317) 808-8802
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hand Surgery 207XS0106X 01092322A Indiana
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 01092322A Indiana

Profile Details

NPI number 1447713920
LBN Legal business name Graham, Jack Gregory
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2019
Last updated Jun 28th, 2024 - about 5 months 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 1447713920 NPPES
Indiana MEDICAID 300085092
Indiana Other 01092322A

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