Individual
DR. RANDALL O CRAFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6036 N 19TH AVE STE 501, PHOENIX, AZ 85015-2143
(602) 899-6444
(602) 899-4161
Mailing address
6036 N 19TH AVE STE 501, PHOENIX, AZ 85015-2143
(602) 899-6444
(602) 899-4161
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
33325
AZ
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
33325
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
896607
—
AZ
Enumeration date
07/05/2006
Last updated
04/16/2020
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