| Dr. Graham Psychiatric Services, Llc | |
|
256 Honeysuckle Rd Ste 2 Dothan AL 36305-1168 | |
| (334) 792-6736 | |
| (334) 792-6737 |
| Full Name | Dr. Graham Psychiatric Services, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 256 Honeysuckle Rd Ste 2, Dothan, Alabama |
| Authorized Official Name and Position | Leona J Graham (OWNER) |
| Authorized Official Contact | 3347926736 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Graham Psychiatric Services, Llc 256 Honeysuckle Rd Ste 2 Dothan AL 36305-1168 Ph: (334) 792-6736 | Dr. Graham Psychiatric Services, Llc 256 Honeysuckle Rd Ste 2 Dothan AL 36305-1168 Ph: (334) 792-6736 |
| NPI Number | 1316444912 |
|---|---|
| Provider Enumeration Date | 04/10/2018 |
| Last Update Date | 04/10/2018 |
| Medicare PECOS PAC ID | 5092059493 |
|---|---|
| Medicare Enrollment ID | O20181211002423 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316444912 | NPI | - | NPPES |
| 003153440A | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | MD.33645 (Alabama) | Primary |
| Provider Name | Leona Jean Graham |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871749572 PECOS PAC ID: 7618293317 Enrollment ID: I20150223001307 |
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