Provider Demographics
NPI:1487667473
Name:GRAFF, WILLIAM T (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:T
Last Name:GRAFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:435-673-9008
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:435-673-9008
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT124012207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT2965OtherPEHP
UT870376618GR1OtherEDUCATORS HEALTH
UT107007727104OtherSELECTHEALTH
UT36074OtherDMBA
UT38520OtherTRICARE
UT107007727104OtherSELECTHEALTH
UT000057655Medicare PIN