Individual
TERRY A. CRAFTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1625 NASHVILLE ST, RUSSELLVILLE, KY 42276-8853
(270) 725-4770
Mailing address
450 TINGLER RD E, RICHMOND, IN 47374-1012
(765) 935-5072
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01032882
IN
207P00000X
Emergency Medicine Physician
Primary
40469
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000031493
BLUE SHIELD - REID HOSP
IN
05
—
0600264
—
OH
Enumeration date
09/20/2006
Last updated
07/09/2007
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