Provider Demographics
NPI:1518933381
Name:FORD, R. CRAIG (AUD)
Entity Type:Individual
Prefix:DR
First Name:R.
Middle Name:CRAIG
Last Name:FORD
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 VALLEY RIVER DR
Mailing Address - Street 2:STE 395
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2132
Mailing Address - Country:US
Mailing Address - Phone:541-689-2107
Mailing Address - Fax:541-743-4179
Practice Address - Street 1:1600 VALLEY RIVER DR STE 395
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2129
Practice Address - Country:US
Practice Address - Phone:541-689-2107
Practice Address - Fax:541-689-2107
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR20567231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR139532OtherMEDICARE PTAN