Individual
DR. TIMOTHY KENT CRAGUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 348-3245
Mailing address
2327 WINDING VW, SAN ANTONIO, TX 78260-7263
(702) 582-4830
(210) 615-6793
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
01054132A
IN
207N00000X
Dermatology Physician
Primary
DO1722
NV
207N00000X
Dermatology Physician
H0063845
MD
207Q00000X
Family Medicine Physician
01054132A
IN
207Q00000X
Family Medicine Physician
H0063845
MD
Other
Enumeration date
06/26/2006
Last updated
11/06/2019
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