JACK L GRAHAM, MD, PC
Dermatology in Roswell, NM

License number
New Mexico 74-39
Category
Osteopathic Medicine
Type
Dermatology
Owner
Name: JACK LYNN GRAHAM M.D.
Title: OWNER
Phone: (505) 623-8100
Address
Address
1600 SE Main St Ste E, Roswell, NM 88203
National Provider ID: 1285730952
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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JACK L. GRAHAM, M.D., PC

Roswell, NM

Industry:
Medical Doctor's Office
Doing business as:
Jack L Graham MD PC
Registration:
Jun 29, 1992
Phone:
(575) 623-8100 (Phone)
Addresses:
1600 SE Main  , Roswell, NM 88203 (Mailing)
1600 SE Main St, Roswell, NM 88203
State ID:
1571694
Business type:
Domestic Profit
Receptionist Secretary, Secretarys:
Jack L Graham (President, Owner, Dermatology, Medical Doctor),Linda Graham (Secretary, Office Manager),Shelly Monk (Medical Assistant),...
Agent:
Jack L Graham Md,1600 SE Main, Roswell, NM 88203 (Physical)

Dermatology licenses in New Mexico

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