Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 7745 | OK |
NPI | 1144327800 |
---|---|
Provider Name | Hugh C Graham |
First Address | Tulsa, OK 74104-5632 |
Second Address | Tulsa, OK 74104-5638 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2006 |
Last Update Date | 24/06/2016 |