Provider Demographics
NPI:1548376585
Name:GRAHAM, JAMES P (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:P
Last Name:GRAHAM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13734 E QUINCY AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-1129
Mailing Address - Country:US
Mailing Address - Phone:303-690-0292
Mailing Address - Fax:303-325-2645
Practice Address - Street 1:13734 E QUINCY AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-1129
Practice Address - Country:US
Practice Address - Phone:303-690-0292
Practice Address - Fax:303-325-2645
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5513111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9360066OtherPHCS
CO5593558OtherFIRSTHEALTH
CO661406OtherUNITED HEALTHCARE
CO5593558OtherFIRSTHEALTH
CO800611Medicare ID - Type Unspecified