Graham Dermatology Center, P.C.

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

20601 Issued in OK

Legal business name

GRAHAM DERMATOLOGY CENTER, P.C.

Practice address

307 E Danforth Rd
Suite 154
Edmond, OK 73034-4483

Phone

(405) 216-0100

NPI assigned

Apr 17, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. David L Graham, M.D.NPI 1912902842

Title

Owner

Phone

(405) 216-0100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Silver Leaf Dermatology Other name

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David L Graham, M.D.

  • Procedural Dermatology Physician
  • Enid, OK
  • NPI 1912902842
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1302998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471564800000",
    "number": "1285924837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 E DANFORTH RD",
            "address_2": "SUITE 154",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730344483",
            "telephone_number": "405-216-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 E DANFORTH RD",
            "address_2": "SUITE 154",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730344483",
            "telephone_number": "405-216-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAHAM DERMATOLOGY CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-17",
        "last_updated": "2016-08-19",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-216-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "OK",
            "license": "20601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1912902842",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Silver Leaf Dermatology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Meghan Goucher
• Robert D Gourley, MD
• Aaron Michael Gowens
• Cheryl Grace, M.S. CCC-SLP
• Gracehealth, PLLC
• Blake Graham
• Joni Lia Graham, LPC-CANDIDATE
• Kaylee Graham
• Patricia Lynn Graham, M.S. SLP
• Wendell Nathaniel Graham

• Procedural Dermatology Physician in Edmond, OK
• Providers in Edmond, OK by specialty
• Procedural Dermatology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.