Individual
KEVIN W CRAIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3217 S PROVIDENCE RD, COLUMBIA, MO 65203-3639
(573) 884-7733
(573) 884-5559
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2259
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2000160622
MO
207QG0300X
Geriatric Medicine (Family Medicine) Physician
2000160622
MO
207QG0300X
Geriatric Medicine (Family Medicine) Physician
31239
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103684
UNITED HEALTHCARE
MO
01
—
157694
BLUE SHIELD
MO
05
—
205839905
—
MO
01
—
480629
HEALTHLINK
MO
01
—
AA37587730
MEDICARE
SC
Enumeration date
05/01/2006
Last updated
04/10/2024
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