Provider Demographics
NPI:1760827570
Name:C CRAIG KARRASCH DPM LTD
Entity Type:Organization
Organization Name:C CRAIG KARRASCH DPM LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GATHINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-786-5561
Mailing Address - Street 1:435 W PLUMB LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3766
Mailing Address - Country:US
Mailing Address - Phone:775-786-5561
Mailing Address - Fax:775-786-5646
Practice Address - Street 1:435 W PLUMB LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3766
Practice Address - Country:US
Practice Address - Phone:775-786-5561
Practice Address - Fax:775-786-5646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-07
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0034213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0351560001Medicare NSC
T67255Medicare UPIN