Provider Demographics
NPI:1164786687
Name:CRAIG SMUCKER, MD ORTHOPAEDICS, PC
Entity Type:Organization
Organization Name:CRAIG SMUCKER, MD ORTHOPAEDICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:SMUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-869-8995
Mailing Address - Street 1:900 W BALTIMORE PIKE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WEST GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19390-9313
Mailing Address - Country:US
Mailing Address - Phone:610-869-8995
Mailing Address - Fax:
Practice Address - Street 1:2600 GLASGOW AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-4773
Practice Address - Country:US
Practice Address - Phone:610-869-8995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-29
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207X00000X, 207XS0114X
DEC1-00007034207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Multi-Specialty
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic TraumaGroup - Multi-Specialty