Individual
DR. JEFFREY C. CRADDOCK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 GROVE RD, GREENVILLE, SC 29605-5611
(864) 455-8431
Mailing address
255 ENTERPRISE BLVD, SUITE 102, GREENVILLE, SC 29615-6300
(864) 454-1142
(864) 454-1144
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
18936
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189361
—
SC
Enumeration date
05/24/2006
Last updated
07/09/2007
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