Provider Demographics
NPI:1477685246
Name:CRAIG, PAUL L (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:L
Last Name:CRAIG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4048 LAUREL ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5333
Mailing Address - Country:US
Mailing Address - Phone:907-274-8200
Mailing Address - Fax:907-274-8211
Practice Address - Street 1:4048 LAUREL ST STE 102
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5389
Practice Address - Country:US
Practice Address - Phone:907-274-8200
Practice Address - Fax:907-274-8211
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAA0205103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist