Provider Demographics
NPI:1578984498
Name:CRAIG SMUCKER MD ORTHOPAEDICS
Entity Type:Organization
Organization Name:CRAIG SMUCKER MD ORTHOPAEDICS
Other - Org Name:SMUCKER ORTHOPAEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:GORDON
Authorized Official - Last Name:SMUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-869-5757
Mailing Address - Street 1:900 W BALTIMORE PIKE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WEST GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19390-9313
Mailing Address - Country:US
Mailing Address - Phone:610-869-5757
Mailing Address - Fax:610-869-6544
Practice Address - Street 1:5936 LIMESTONE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-8930
Practice Address - Country:US
Practice Address - Phone:610-869-5757
Practice Address - Fax:610-869-6544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1000-7034261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty