Provider Demographics
NPI:1336403260
Name:MCCRAW, CASEY OWEN (MD)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:OWEN
Last Name:MCCRAW
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 1:7500 SMOKE RANCH RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0373
Mailing Address - Country:US
Mailing Address - Phone:702-233-0727
Mailing Address - Fax:702-233-4799
Practice Address - Street 1:8915 S PECOS RD STE 19A
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074
Practice Address - Country:US
Practice Address - Phone:702-341-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV17981208800000X
GA005527208800000X
AL35901208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0366100001OtherCIGNA GOVERNMENT SVC PTAN
AL0366100001OtherMEDICARE NSC