Provider Demographics
NPI:1700294022
Name:CRAIG, ADORIS
Entity Type:Individual
Prefix:PROF
First Name:ADORIS
Middle Name:
Last Name:CRAIG
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ADORIS
Other - Middle Name:
Other - Last Name:ANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:505 WHISPERING OAKS RD
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:OK
Mailing Address - Zip Code:74873-2347
Mailing Address - Country:US
Mailing Address - Phone:405-206-1518
Mailing Address - Fax:
Practice Address - Street 1:RR 1 BOX 131C
Practice Address - Street 2:
Practice Address - City:EUFAULA
Practice Address - State:OK
Practice Address - Zip Code:74432-9223
Practice Address - Country:US
Practice Address - Phone:918-452-3335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-30
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator