Individual
DR. DUANE ELDON CRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M7929
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010028256
REGENCE BLUE SHIELD
ID
01
—
000010028257
REGENCE BLUE SHIELD
ID
05
—
1609886514
—
MT
05
—
805750600
—
ID
05
—
8267114
—
WA
01
—
J3953
BLUE CROSS OF IDAHO
ID
01
—
J3995
BLUE CROSS OF IDAHO
ID
Enumeration date
08/09/2006
Last updated
05/29/2025
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