Individual
DR. CRAIG K SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
37 HERSCHEL ST, CARIBOU, ME 04736-2426
(207) 496-5111
(207) 498-6502
Mailing address
37 HERSCHEL ST, CARIBOU, ME 04736-2426
(207) 496-5111
(207) 498-6502
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT736
ME
152WC0802X
Corneal and Contact Management Optometrist
OPT736
ME
152WP0200X
Pediatric Optometrist
OPT736
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010429521
PROVIDER ID
ME
01
—
0253910001
DMERC PROVIDER ID
ME
05
—
118340099
—
ME
01
—
P00071063
RAILROAD MEDICARE ID
ME
Enumeration date
06/26/2006
Last updated
02/16/2022
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