Individual
MR. JACKSON L CRAIG
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6230 MAIN STREET, COLSTRIP, MT 59323-1858
(406) 748-3600
(406) 748-3606
Mailing address
6230 MAIN STREET, P O BOX 1858, COLSTRIP, MT 59323-1858
(406) 748-3600
(406) 748-3606
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
72
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0432302
—
MT
Enumeration date
02/22/2006
Last updated
07/08/2007
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