Provider Demographics
NPI:1508874850
Name:CRAFTON, EUGENE MIDDLETON (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:MIDDLETON
Last Name:CRAFTON
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 1:1035 WELLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-8122
Mailing Address - Country:US
Mailing Address - Phone:970-683-4802
Mailing Address - Fax:970-242-1070
Practice Address - Street 1:1035 WELLINGTON AVE
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-8122
Practice Address - Country:US
Practice Address - Phone:970-683-4802
Practice Address - Fax:970-242-1070
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS15291207RG0100X
CO46937207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00112878Medicaid
CO68804059Medicaid
COP00658273OtherRRPTAN
COP00658273OtherRRPTAN
MS100000092Medicare ID - Type Unspecified
MSF67203Medicare UPIN