Individual
DR. CRAIG KENNETH HALLSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-8173
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-8173
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
18514
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07076371
—
MS
05
—
157470
—
AL
05
—
1603767
—
LA
01
—
512I370060
MEDICARE PTAN
MS
Enumeration date
06/16/2006
Last updated
04/01/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us