Provider Demographics
NPI:1609846054
Name:BOTTONI, CRAIG R (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:R
Last Name:BOTTONI
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1 JARRETT WHITE RD
Mailing Address - Street 2:ORTHOPAEDIC SURG SERVICE, MCHK-DSO
Mailing Address - City:TRIPLER ARMY MEDICAL CENTER
Mailing Address - State:HI
Mailing Address - Zip Code:96859-5001
Mailing Address - Country:US
Mailing Address - Phone:808-433-5969
Mailing Address - Fax:808-433-1554
Practice Address - Street 1:1 JARRETT WHITE RD
Practice Address - Street 2:ORTHOPAEDIC SURG SERVICE, MCHK-DSO
Practice Address - City:TRIPLER ARMY MEDICAL CENTER
Practice Address - State:HI
Practice Address - Zip Code:96859-5001
Practice Address - Country:US
Practice Address - Phone:808-433-5969
Practice Address - Fax:808-433-1554
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2012-10-04
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Provider Licenses
StateLicense IDTaxonomies
FLME63645207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine