Provider Demographics
NPI:1508823485
Name:CRAIG, CHARLES C (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:C
Last Name:CRAIG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:800 MEDICAL DRIVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-3765
Mailing Address - Country:US
Mailing Address - Phone:316-283-9977
Mailing Address - Fax:316-283-0966
Practice Address - Street 1:800 MEDICAL DRIVE
Practice Address - Street 2:SUITE 240
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-3765
Practice Address - Country:US
Practice Address - Phone:316-283-9977
Practice Address - Fax:316-283-0966
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2013-01-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS04-15116207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS668050OtherFIRST HEALTH NETWORK
KS042441OtherTRICARE
KS200037434OtherRR MEDICARE
KS4097036OtherAETNA
KS1318290001OtherCIGNA
KS100086660GMedicaid
KS198OtherPREFERRED HEATH CARE
KS4097036OtherAETNA
KS198OtherPREFERRED HEATH CARE