JACK L GRAHAM, MD, PC
NPI 1285730952
Dermatology in Roswell, NM

Active since September 16, 2006
1600 SE MAIN ST STE E, ROSWELL, NM 88203(505) 623-8100(505) 623-8101 Get Directions Write a Review

NPPES record last updated: July 11, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jack L Graham, Md, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK L GRAHAM, MD, PC (NPI 1285730952) is a healthcare organization registered as a dermatology in Roswell, New Mexico and active in the NPI registry since September 2006. The organization lists Jack Lynn Graham, Owner, as its authorized official.

NPPES Registry Identity

NPI1285730952
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameJACK L GRAHAM, MD, PC
Location Address1600 SE MAIN ST STE ERoswell, NM 88203-5423
Mailing Address1600 Se Main St Ste ERoswell, NM 88203-5423 · (505) 623-8100 · Fax (505) 623-8101
Fax(505) 623-8101
Organization SubpartNo
Authorized OfficialJack Lynn GrahamOwner · (505) 623-8100
Enumeration DateSeptember 16, 2006
Last NPPES UpdateJuly 11, 2008
NPI 1285730952 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License Licensed in NM · 74-39
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
1600 SE MAIN ST STE E, Roswell, NM 88203

Other Identifiers 3

Medicare UPIND35666NM
Medicaid11023NM
Medicare PIN2124054NM

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dermatology
1600 SE MAIN ST STE E
ROSWELL, NM 88203

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack L Graham, MD, PC's NPI number?

The NPI number for Jack L Graham, MD, PC is 1285730952. It was assigned to this organization in the NPPES registry on September 16, 2006.

Where is Jack L Graham, MD, PC located?

Jack L Graham, MD, PC is located at 1600 SE Main St Ste E, Roswell, NM 88203. The listed phone number is (505) 623-8100.

What is Jack L Graham, MD, PC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

When was this NPI record last updated?

The NPPES record for Jack L Graham, MD, PC was last updated on July 11, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.