Provider Demographics
NPI:1629012877
Name:STRAFFORD, JAMES CRAIG (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:CRAIG
Last Name:STRAFFORD
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 1:446 MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-2348
Mailing Address - Country:US
Mailing Address - Phone:513-834-7063
Mailing Address - Fax:513-873-1567
Practice Address - Street 1:485 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:OH
Practice Address - Zip Code:45177
Practice Address - Country:US
Practice Address - Phone:513-834-7063
Practice Address - Fax:513-873-1567
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.035122207RA0401X
WV15121207V00000X
OH35-03-5122207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
001714045OtherMOUNTAIN STATE BCBS
OH0277847Medicaid
OH000000181636OtherUNISON MEDICAID #
WV0049166000Medicaid
OH0277847OtherMOLINA MEDICAID #
000000007680OtherANTHEM BCBS
OH310917085137OtherCARESOURCE MEDICAID #
OH160017401OtherRR MEDICARE
OH000000181636OtherUNISON MEDICAID #
C34948Medicare UPIN
OH0277847OtherMOLINA MEDICAID #