| Dr Blake D Graham, MD | |
|
1650 Cochrane Cir, Pediatrics, Ft Carson, CO 80913-4603 | |
| (719) 526-7653 | |
| Not Available |
| Full Name | Dr Blake D Graham |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 1650 Cochrane Cir, Ft Carson, Colorado |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639130180 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | DR.0054808 (Colorado) | Primary |
| 208000000X | Pediatrics | 274742-1205 (Utah) | Secondary |
| Entity Name | Valley View Hospital Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376134841 PECOS PAC ID: 1850294778 Enrollment ID: O20040129000027 |
| Entity Name | Alpine Medical Group Colorado PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104501873 PECOS PAC ID: 1759743347 Enrollment ID: O20230814002966 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Blake D Graham, MD 1650 Cochrane Cir, Colorado Springs, CO 80913-4613 Ph: (719) 526-9085 | Dr Blake D Graham, MD 1650 Cochrane Cir, Pediatrics, Ft Carson, CO 80913-4603 Ph: (719) 526-7653 |
Dr. Teodora Thompson, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1650 Cochrane Cir Unit Meddac, Ft Carson, CO 80913 Phone: 719-526-7000 |
Katherine Buechner, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1650 Cochrane Cir # B7500, Ft Carson, CO 80913 Phone: 719-526-7000 |