Provider Demographics
NPI:1083897771
Name:WILLIAM T GRAFF MD FAAFP PC
Entity Type:Organization
Organization Name:WILLIAM T GRAFF MD FAAFP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:T
Authorized Official - Last Name:GRAFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:435-673-9653
Mailing Address - Street 1:630 S 400 E STE 101
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-3765
Mailing Address - Country:US
Mailing Address - Phone:435-673-9653
Mailing Address - Fax:
Practice Address - Street 1:630 S 400 E STE 101
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-3765
Practice Address - Country:US
Practice Address - Phone:435-673-9653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT162245-1205261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTC63415Medicare UPIN