NPI 1164572848

Philip Randle Graham, OD

Practitioner Optometrist Pontotoc, MS

Practice location

Address: 14 E Marion St, Pontotoc, MS 38863-2813
Phone: (662) 489-4741
Fax: (662) 489-2940
Mailing address: PO Box 120, Pontotoc, MS 38863-0120

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 491 (MS)

Other Optometrist providers in Mississippi →

Registry record

NPI: 1164572848
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Jan 2007
Record last updated: 10 Nov 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.