Provider Demographics
NPI:1407080963
Name:MCCRACKEN, DOUGLAS SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:SCOTT
Last Name:MCCRACKEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-2334
Mailing Address - Fax:717-851-3498
Practice Address - Street 1:605 S GEORGE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17401-3160
Practice Address - Country:US
Practice Address - Phone:717-851-2334
Practice Address - Fax:717-851-3498
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD446011207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA418500OtherUPMC
PA30123296OtherAMERIHEALTH MERCY-WGER
PA30152969OtherAMERIHEALTH CARITAS PA - WMG - CAREEXPRESS
PA30153213OtherAMERIHEALTH CARITAS PA - WMG - WS READYCARE
PAP009970OtherGATEWAY
PA102729724Medicaid
PA30120315OtherAMERIHEALTH MERCY - WMG
PA2714642OtherHIGHMARK BLUE SHIELD
PA418500OtherUPMC
PA30120315OtherAMERIHEALTH MERCY - WMG