National Provider Identifier Database

JEAN GRAHAM, MD – NPI #1508920661
Specialist

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.


Contact Information

JEAN GRAHAM, MD
4801 N BUTLER AVE
FARMINGTON, NM87401-6002
Phone: 505-324-8375
Fax:
Website:
Specialty Taxonomy Code
* Specialist 174400000X

* Indicates primary specialty

NPI Profile & details for JEAN GRAHAM

NPI Number 1508920661
Credentials MD
Entity Individual
Enumeration date 12/21/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor1 Yes
Identifiers
  • NM License #: 97-254
  • NM Medicaid: Q2833
  • CO Other: 84-1497491-001 ROCKY MT HMO
  • NM Other: NM012425 BLUE CROSS BLUE SHIELD NM
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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