Provider Demographics
NPI:1851356299
Name:DAVIS, CRAIG ALAN (MD)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:ALAN
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1411 S POTOMAC ST
Mailing Address - Street 2:STE 400
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012
Mailing Address - Country:US
Mailing Address - Phone:303-695-6060
Mailing Address - Fax:303-369-7776
Practice Address - Street 1:1411 S POTOMAC ST
Practice Address - Street 2:STE 400
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012
Practice Address - Country:US
Practice Address - Phone:303-695-6060
Practice Address - Fax:303-369-7776
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35498207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01354984Medicaid
CO01354984Medicaid
COCL8278Medicare ID - Type Unspecified