Provider Demographics
NPI:1285455782
Name:GRAF, ALISON ELIZABETH
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:ELIZABETH
Last Name:GRAF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 POPLAR TER
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-1871
Mailing Address - Country:US
Mailing Address - Phone:678-477-5718
Mailing Address - Fax:
Practice Address - Street 1:805 POPLAR TER
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-1871
Practice Address - Country:US
Practice Address - Phone:678-477-5718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN296314207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine