Male or Other

Dr. Larry C. Graham MD

Body Imaging Physician in Wichita, KS(View on Map)

Full Name

Dr. Larry C Graham MD

NPI Number

1023090503

NPI Type

Individual Provider

Gender

Male

Enumeration Date

11/18/2005

Licenses

State

Kansas

License Number

04-28763

Contact
Information

Purpose

Mailing
Location

Address

13715 PINNACLE DR
3600 E HARRY ST

City

Wichita
Wichita

State

KS
KS

Postal Code

67230-1545
67218-3713

Country

US
US

Telephone Number

(316) 733-2307
(316) 689-5050

Identifiers

Identifier

100420330C
100173090A
1023090503
300132252

Identifier State

KS
OK
MO
KS

Identifier Issuer

Unknown
Unknown
Unknown
RR MEDICARE

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 11/20/2013

Provider Address

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