Provider Demographics
NPI:1336878966
Name:DONALSON, CRAIG MILLER
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:MILLER
Last Name:DONALSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 SPRING LAKE DR
Mailing Address - Street 2:
Mailing Address - City:FORTSON
Mailing Address - State:GA
Mailing Address - Zip Code:31808-5340
Mailing Address - Country:US
Mailing Address - Phone:706-577-7362
Mailing Address - Fax:
Practice Address - Street 1:248 SPRING LAKE DR
Practice Address - Street 2:
Practice Address - City:FORTSON
Practice Address - State:GA
Practice Address - Zip Code:31808-5340
Practice Address - Country:US
Practice Address - Phone:706-577-7362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer