Provider Demographics
NPI:1952405607
Name:GRAVES, JOHN M (DO)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:M
Last Name:GRAVES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:3309 SW 34TH CIRCLE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474
Mailing Address - Country:US
Mailing Address - Phone:352-237-2400
Mailing Address - Fax:352-237-9808
Practice Address - Street 1:1500 SW 1ST AVENUE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471
Practice Address - Country:US
Practice Address - Phone:352-351-7200
Practice Address - Fax:904-824-2226
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS6266207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL050091209OtherRR MEDICARE
FL371047500Medicaid
FL371047500Medicaid
FL80699AMedicare ID - Type Unspecified