Provider Demographics
NPI:1689975740
Name:CRAIG C. DAVIS, MD, PL
Entity Type:Organization
Organization Name:CRAIG C. DAVIS, MD, PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:C
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACP
Authorized Official - Phone:239-304-3030
Mailing Address - Street 1:201 8TH ST S STE 304
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-6117
Mailing Address - Country:US
Mailing Address - Phone:239-304-3030
Mailing Address - Fax:239-643-3030
Practice Address - Street 1:201 8TH ST S STE 304
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6117
Practice Address - Country:US
Practice Address - Phone:239-304-3030
Practice Address - Fax:239-643-3030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care