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Individual

BRUCE L CRAIG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD FAAFP

Contact information

Practice address
3819 PATTERSON ST, POLLOCK, LA 71467
(318) 765-3750
Mailing address
124 RED OAK LOOP, POLLOCK, LA 71467-4341
(318) 765-9020

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
013065
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010051840
RAILROAD MEDICARE
05
1162736
LA
Enumeration date
09/06/2005
Last updated
12/08/2009
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