Provider Demographics
NPI:1871749572
Name:GRAHAM, LEONA JEAN (MD)
Entity type:Individual
Prefix:
First Name:LEONA
Middle Name:JEAN
Last Name:GRAHAM
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1108 ROSS CLARK CIR
Mailing Address - Street 2:SOUTHEAST ALABAMA MEDICAL CENTER
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-3022
Mailing Address - Country:US
Mailing Address - Phone:334-794-4582
Mailing Address - Fax:334-671-9877
Practice Address - Street 1:1865 HONEYSUCKLE RD STE 2
Practice Address - Street 2:SOUTHEAST ALABAMA MEDICAL CENTER- ALTACARE
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-4287
Practice Address - Country:US
Practice Address - Phone:334-794-4582
Practice Address - Fax:334-671-9877
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2015-02-05
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Provider Licenses
StateLicense IDTaxonomies
AL336452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry