Provider Demographics
NPI:1437359056
Name:GRAHAM, JOSEPH MARK (DO)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MARK
Last Name:GRAHAM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:PO BOX 112727
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32611-2727
Mailing Address - Country:US
Mailing Address - Phone:352-273-7002
Mailing Address - Fax:352-273-7388
Practice Address - Street 1:120 HEALTH PARK BLVD
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-3701
Practice Address - Country:US
Practice Address - Phone:888-481-2135
Practice Address - Fax:386-627-7319
Is Sole Proprietor?:No
Enumeration Date:2007-07-22
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS11534207XS0117X, 207X00000X, 207X00000X, 207X00000X
MO2013009584207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1437359056OtherFIRST HEALTH NETWORK
FL1437359056OtherCIGNA
FL1437359056OtherASCENSION HEALTH
FL1437359056OtherHUMANA MILITARY
FLPENDINGOtherAETNA
FL14KA4EOtherBCBS
FL004857900Medicaid
FL113717600Medicaid
FL1437359056OtherPARADIGM
FL759044500OtherCSNI - DEPT OF LABOR
FL759044900OtherCSNI - DEPT OF LABOR
FL1437359056OtherHUMANA
FL1437359056OtherPRIME HEALTH SERVICES, INC.