Provider Demographics
NPI:1396747325
Name:MCCABE, CRAIG FREDRICK (MD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:FREDRICK
Last Name:MCCABE
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 1:122 HERITAGE PARK DRIVE
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129
Mailing Address - Country:US
Mailing Address - Phone:615-904-9024
Mailing Address - Fax:615-904-0337
Practice Address - Street 1:122 HERITAGE PARK DR
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129
Practice Address - Country:US
Practice Address - Phone:615-904-9024
Practice Address - Fax:615-904-0337
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2018-07-13
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-03-29
Provider Licenses
StateLicense IDTaxonomies
TNMD0000031525207W00000X
TN31525207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3718467Medicaid
3718467Medicare PIN
G93682Medicare UPIN
TN3718467Medicaid