Individual
CRAIG W. IRWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
630 SOUTHPOINT DR, LEXINGTON, KY 40515-6350
(859) 272-1928
(859) 271-9601
Mailing address
630 SOUTHPOINT DR, LEXINGTON, KY 40515-6350
(859) 272-1928
(859) 271-9601
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36288
KY
208000000X
Pediatrics Physician
36288
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37903705
MEDICAID LAB GRP
KY
01
—
400501
MEDICARE LAB GRP
KY
05
—
64026065
—
KY
01
—
CB5773
RR MEDICARE GRP
GA
Enumeration date
07/14/2006
Last updated
11/02/2007
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