Provider Demographics
NPI:1043229412
Name:PHILLIPS, CRAIG HUDGINS (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:HUDGINS
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 RIVERTON COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630-6768
Mailing Address - Country:US
Mailing Address - Phone:540-635-0848
Mailing Address - Fax:
Practice Address - Street 1:67 RIVERTON COMMONS DR
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-6768
Practice Address - Country:US
Practice Address - Phone:540-635-0848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA67308207Q00000X
VA0101255950207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA343937YWAUMedicare PIN
KY45389OtherMEDICAL LICENSE