Provider Demographics
NPI:1831437078
Name:JAMES T CRAIG JR MD INC
Entity type:Organization
Organization Name:JAMES T CRAIG JR MD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:731-234-1162
Mailing Address - Street 1:11 OKEENA DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-8819
Mailing Address - Country:US
Mailing Address - Phone:731-668-6540
Mailing Address - Fax:731-668-2727
Practice Address - Street 1:1004 GREYSTONE SQ
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-3580
Practice Address - Country:US
Practice Address - Phone:731-668-7375
Practice Address - Fax:731-668-2727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-23
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD4665261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty