Graham, Russell M

Graham, Russell M is an individual health care provider with primary practice located at 119 Pleasant Lake Ct , Jackson MO 63755-6864. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Graham, Russell M can be contacted via phone (573) 204-1046.

Contact Information

Primary practice address
119 Pleasant Lake Ct Jackson MO 63755-6864
Phone: (573) 204-1046
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MO2007034232 Missouri

Profile Details

NPI number 1265484919
LBN Legal business name Graham, Russell M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Mar 18th, 2010 - about 14 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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