Dr Jackie Lynn Graham Iv, MD in Roswell, NM - Dermatology

Dr Jackie Lynn Graham Iv, MD is a Dermatology physician based in Roswell, New Mexico. Dr Jackie Lynn Graham Iv is licensed to practice in New Mexico (license number 74-39) and his current practice location is 1600 Se Main St Ste E, Roswell, New Mexico. He can be reached at his office (for appointments etc.) via phone at (505) 623-8100.

NPI number for Dr Jackie Lynn Graham Iv is 1497851166 and his current mailing address is 1600 Se Main St Ste E, Roswell, New Mexico. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1497851166.

Contact Information

	Dr Jackie Lynn Graham Iv, MD
	1600 Se Main St Ste E, Roswell, NM 88203-5423
	(505) 623-8100
	(505) 623-8101

Physician's Profile

Full Name	Dr Jackie Lynn Graham Iv
Gender	Male
Speciality	Dermatology
Location	1600 Se Main St Ste E, Roswell, New Mexico
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

NPI Data:

NPI Number: 1497851166
Provider Enumeration Date: 09/16/2006
Last Update Date: 07/08/2008

Medical Identifiers

Medical identifiers for Dr Jackie Lynn Graham Iv such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1497851166	NPI	-	NPPES
11023	Medicaid	NM

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207N00000X	Dermatology	74-39 (New Mexico)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jackie Lynn Graham Iv is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Jackie Lynn Graham Iv, MD 1600 Se Main St Ste E, Roswell, NM 88203-5423 Ph: (505) 623-8100	Dr Jackie Lynn Graham Iv, MD 1600 Se Main St Ste E, Roswell, NM 88203-5423 Ph: (505) 623-8100

News Archive

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Dr Jackie Lynn Graham Iv, MD - Dermatology in Roswell, NM