Provider Demographics
NPI:1558455162
Name:JEX, CRAIG T (DPM)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:T
Last Name:JEX
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:9300 STOCKDALE HWY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-3613
Mailing Address - Country:US
Mailing Address - Phone:661-663-8483
Mailing Address - Fax:661-663-3095
Practice Address - Street 1:840 TUCKER RD
Practice Address - Street 2:SUITE G
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561-2564
Practice Address - Country:US
Practice Address - Phone:661-822-5537
Practice Address - Fax:661-822-5531
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2023-10-27
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Provider Licenses
StateLicense IDTaxonomies
CAE4740213ES0103X
MI5901002043213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
000E4700OtherBLUE SHIELD
CAAN573Medicare UPIN