Provider Demographics
NPI:1235830118
Name:MCCRACKEN, WILLIAM JR
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:MCCRACKEN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BUCKINGHAM CT
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2402
Mailing Address - Country:US
Mailing Address - Phone:410-925-5200
Mailing Address - Fax:
Practice Address - Street 1:203 MCCRACKEN ST
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-4631
Practice Address - Country:US
Practice Address - Phone:410-925-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility