Individual
MR. CHARLES J CRAFTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
14 RICHLAND MEDICAL PARK DR STE 350, COLUMBIA, SC 29203-6896
(803) 434-1663
(803) 434-3894
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50.002054
OH
363A00000X
Physician Assistant
Primary
PA1989
SC
363AS0400X
Surgical Physician Assistant
50-002054
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1724PA
—
SC
05
—
95003851
—
KY
Enumeration date
03/29/2006
Last updated
06/08/2022
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