Individual
MR. CRAIG K GILCREASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
502 ELM ST NE, ALBUQUERQUE, NM 87102-2512
(505) 841-1000
(505) 843-2592
Mailing address
502 ELM ST NE, ALBUQUERQUE, NM 87102-2512
(505) 841-1000
(505) 843-2956
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA2003-0047
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
223634
—
AZ
01
—
P00428450
RAILROAD MEDICARE
AZ
Enumeration date
01/09/2007
Last updated
08/01/2014
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