Individual
KIMBERLY A CRADOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
996 NW CIRCLE BLVD STE 103, CORVALLIS, OR 97330-1485
(541) 768-1252
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036116793
IL
208600000X
Surgery Physician
Primary
MD226613
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6447860011
—
IL
Enumeration date
08/31/2006
Last updated
12/08/2025
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