Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | MD23686 | TN |
NPI | 1306834619 |
---|---|
Provider Name | Dr. Joe Alan Graves |
First Address | Knoxville, TN 37916-2219 |
Second Address | Knoxville, TN 37916-2219 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2005 |
Last Update Date | 03/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E92502 | (02) |