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Individual

DR. CRAIG MICHAEL CARPENTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1433 N 1075 W STE 104, FARMINGTON, UT 84025-2746
(801) 298-1300
(801) 296-6199
Mailing address
PO BOX 25488, SALT LAKE CITY, UT 84125-0488
(800) 475-3698
(801) 296-6199

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
166676-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003637600
ID
05
06777
UT
05
120728800
WY
05
926975
AZ
01
P00205419
RR MEDICARE
UT
01
P00651520
RR MEDICARE
UT
Enumeration date
07/12/2005
Last updated
02/26/2019
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