Provider Demographics
NPI:1164744801
Name:ROBERT L. CRAIG, M.D., L.L.C.
Entity Type:Organization
Organization Name:ROBERT L. CRAIG, M.D., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:CRIAG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-363-2050
Mailing Address - Street 1:504 JACK MILLER RD STE 6
Mailing Address - Street 2:
Mailing Address - City:VILLE PLATTE
Mailing Address - State:LA
Mailing Address - Zip Code:70586-5600
Mailing Address - Country:US
Mailing Address - Phone:337-363-2050
Mailing Address - Fax:
Practice Address - Street 1:504 JACK MILLER RD STE 6
Practice Address - Street 2:
Practice Address - City:VILLE PLATTE
Practice Address - State:LA
Practice Address - Zip Code:70586-5600
Practice Address - Country:US
Practice Address - Phone:337-363-2050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.018465208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty