Provider Demographics
NPI:1437595998
Name:CREIGHTON, JAMES BERNARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BERNARD
Last Name:CREIGHTON
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 1:8345 NW 66TH ST
Mailing Address - Street 2:A7484
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166-2626
Mailing Address - Country:US
Mailing Address - Phone:732-993-5569
Mailing Address - Fax:
Practice Address - Street 1:8345 NW 66TH ST
Practice Address - Street 2:A7484
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-2626
Practice Address - Country:US
Practice Address - Phone:732-993-5569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-10
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME113412207Q00000X
HI7256207Q00000X
TN35498207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine