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NPI Code Detail

MEDICARE: DR. CRAIG DAVID SANDERS DO

MEDICARE: DR. CRAIG DAVID SANDERS DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician02741KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821059791
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CRAIG DAVID SANDERS DO
Provider Business Mailing Address
First Line : 605 MAN O WAR BOULEVARD
Second Line :
City : UNION
State : KY
Zip : 41091-2007
Country : US
Telephone Number : 859-578-5333
Fax Number : 859-384-0216
Provider Business Practice Location Address
First Line : 605 MAN O WAR BOULEVARD
Second Line :
City : UNION
State : KY
Zip : 41091-2007
Country : US
Telephone Number : 859-578-5333
Fax Number : 859-384-0216
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2006
Last Update Date : 11/07/2025

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