Provider Demographics
NPI:1134291263
Name:BUETTNER, CRAIG M (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:M
Last Name:BUETTNER
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 1:100 RICE MINE ROAD LOOP
Mailing Address - Street 2:SUITE 206
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-2414
Mailing Address - Country:US
Mailing Address - Phone:205-339-0171
Mailing Address - Fax:205-333-8681
Practice Address - Street 1:100 RICE MINE ROAD LOOP
Practice Address - Street 2:SUITE 206
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-2414
Practice Address - Country:US
Practice Address - Phone:205-339-0171
Practice Address - Fax:205-333-8681
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00016599207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1104250001Medicare NSC
ALF29539Medicare UPIN