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Individual

DR. JONATHAN M CRAIGHEAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1225 WEST STADIUM BLVD, JEFFERSON CITY, MO 65109
(573) 635-8000
(573) 556-1710
Mailing address
PO BOX 104240, JEFFERSON CITY, MO 65110-4240
(573) 635-5264
(573) 556-1710

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2004010827
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
207392408
MO
01
CD6058
RAILROAD GROUP
MO
01
P00233081
MEDICARE RAILROAD
MO
Enumeration date
12/22/2005
Last updated
06/28/2023
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