Individual
DR. DUANE ELDON CRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 W IRONWOOD DR, STE 155, COEUR D ALENE, ID 83814-2656
(208) 667-0585
(208) 667-0876
Mailing address
700 W IRONWOOD DR, STE 155, COEUR D ALENE, ID 83814-2656
(208) 667-0585
(208) 625-2075
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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