Graham, Jon Wessley
Graham, Jon Wessley is an individual health care provider with primary practice located at 1702 University Dr S , Fargo ND 58103-4940. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Graham, Jon Wessley can be contacted via phone (701) 364-3000.Contact Information
Primary practice address
1702 University Dr S
Fargo ND 58103-4940
Phone: (701) 364-3000
Fax: (701) 364-8906
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | ME39776 | Florida |
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 12272 | North Dakota |
Profile Details
| NPI number | 1992752968 |
|---|---|
| LBN Legal business name | Graham, Jon Wessley |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 27th, 2006 |
| Last updated | Jul 11th, 2012 - about 12 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 | 1992752968 | NPPES |
| North Dakota | MEDICAID | 16842 |
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