Jack Gregory Graham, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Philadelphia, Pennsylvania. His current practice location is
925 Chestnut Street, 5th Floor, Philadelphia, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at
(610) 703-7396.
Jack Gregory Graham is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1447713920.
Physician's Profile
Full Name | Jack Gregory Graham |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 925 Chestnut Street, Philadelphia, Pennsylvania |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1447713920
- Provider Enumeration Date: 04/10/2019
- Last Update Date: 04/01/2024
Medicare PECOS Information:
- PECOS PAC ID: 9537492715
- Enrollment ID: I20190603000501
Medical Identifiers
Medical identifiers for Jack Gregory Graham such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1447713920 | NPI | - | NPPES |
01092322A | Other | IN | STATE LICENSE |
300085092 | Medicaid | IN | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207X00000X | Orthopaedic Surgery | 01092322A (Indiana) | Secondary |
207XS0106X | Orthopaedic Surgery - Hand Surgery | 01092322A (Indiana) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | 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. Jack Gregory Graham is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jack Gregory Graham, MD 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107-4206 Ph: (610) 703-7396 | Jack Gregory Graham, MD 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107-4206 Ph: (610) 703-7396 |
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