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:
Health care specialties
Specialty | Code | License # | 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 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 | 1710094180 | NPPES |
Tennessee | MEDICAID | 3026054 |
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