DR. STEPHEN J. GRAHAM M.D. NPI 1790778520

NPI Information

NPI: 1790778520
Provider Name: DR. STEPHEN J. GRAHAM, M.D.
Classification: General Practice - 208D00000X
Entity Type: Individual
Address:
9983 E DESERT TRAIL LN
GOLD CANYON, AZ
ZIP 85118
Phone: (406) 425-1355
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DR. Stephen J. Graham, M.D. is a general practice in Gold Canyon, AZ. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee DR. Stephen J. Graham, M.D. NPI is 1790778520. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

9983 E DESERT TRAIL LN
GOLD CANYON, AZ
ZIP 85118-922
Phone: (406) 425-1355
Fax: (801) 618-4185

The enumeration date for this NPI number is 8/26/2005 and was last updated on 7/13/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	207W00000X	Ophthalmology	19987	ARIZONA	No
2	207W00000X	Ophthalmology	184400-1205	UTAH	No
3	208D00000X	General Practice	184400-1205	UTAH	Yes
4	208D00000X	General Practice	19987	ARIZONA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	508021	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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