Provider Demographics
NPI:1346211745
Name:BELK, CRAIG R (OD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:R
Last Name:BELK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:12199 HWY 49
Mailing Address - Street 2:STE 100
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503
Mailing Address - Country:US
Mailing Address - Phone:228-832-1832
Mailing Address - Fax:228-832-5115
Practice Address - Street 1:12199 HWY 49
Practice Address - Street 2:STE 100
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503
Practice Address - Country:US
Practice Address - Phone:228-832-1832
Practice Address - Fax:228-832-5115
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSMS573152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist