Provider Demographics
NPI:1225257553
Name:CRAFT, YANCY (MD, MPH)
Entity Type:Individual
Prefix:
First Name:YANCY
Middle Name:
Last Name:CRAFT
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9178
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72811-9178
Mailing Address - Country:US
Mailing Address - Phone:479-968-4273
Mailing Address - Fax:479-968-1363
Practice Address - Street 1:2719 SE I ST
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3996
Practice Address - Country:US
Practice Address - Phone:479-273-5437
Practice Address - Fax:479-273-9932
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-6829208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics