Organization
CRAIG ALLEN GUSTAFSON MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG A GUSTAFSON MD (OWNER)
(970) 242-1566
Entity
Organization
Contact information
Practice address
2478 PATTERSON RD, SUITE 27, GRAND JUNCTION, CO 81505-1266
(970) 242-1566
(970) 263-0134
Mailing address
PO BOX 6971, LINCOLN, NE 68506-0971
(402) 486-7020
(402) 434-6037
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23176822
—
CO
01
—
DB9937
RAILROAD MEDICARE
CO
Enumeration date
10/27/2006
Last updated
01/31/2008
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