Provider Demographics
NPI:1831537356
Name:CRAIG, JENNIFER MICHELLE (OD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MICHELLE
Last Name:CRAIG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 GRANDVIEW PKWY
Mailing Address - Street 2:APARTMENT 237
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-1949
Mailing Address - Country:US
Mailing Address - Phone:205-566-2720
Mailing Address - Fax:
Practice Address - Street 1:1600 MONTCLAIR RD
Practice Address - Street 2:
Practice Address - City:IRONDALE
Practice Address - State:AL
Practice Address - Zip Code:35210-2410
Practice Address - Country:US
Practice Address - Phone:205-951-3268
Practice Address - Fax:205-956-9753
Is Sole Proprietor?:No
Enumeration Date:2013-06-06
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-C96152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist