Basic Information
| Provider Information | |||||||||
| NPI: | 1316973100 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GRAFF | ||||||||
| FirstName: | JASON | ||||||||
| MiddleName: | CHARLES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 229 | ||||||||
| Address2: | |||||||||
| City: | WAKEFIELD | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028800229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4017888757 | ||||||||
| FaxNumber: | 4017829867 | ||||||||
| Practice Location | |||||||||
| Address1: | 14 WOODRUFF AVE | ||||||||
| Address2: | |||||||||
| City: | NARRAGANSETT | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028823476 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4017882110 | ||||||||
| FaxNumber: | 4017882130 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2006 | ||||||||
| LastUpdateDate: | 03/22/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | 04-30437 | KS | N | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RP1001X | 2002016475 | MO | N | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RP1001X | MD17738 | RI | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.