Individual
RYAN CRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
122 12TH ST, PRINCETON, WV 24740
(304) 487-7047
Mailing address
118 12TH STREET EXT, PRINCETON, WV 24740-2352
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
3295
WV
208M00000X
Hospitalist Physician
Primary
3295
WV
Other
Enumeration date
04/08/2015
Last updated
11/18/2019
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