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NPI Code Detail

MEDICARE: CRAIG ANTHONY VITRANO MD

MEDICARE: CRAIG ANTHONY VITRANO MD
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
12083X0100XOccupational Medicine Physician015097LA

General Provider Information

NPI Number : 1972501690
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRAIG ANTHONY VITRANO MD
Provider Business Mailing Address
First Line : 6757 BURDEN LN
Second Line :
City : BATON ROUGE
State : LA
Zip : 70808-4212
Country : US
Telephone Number : 225-767-0940
Fax Number : 225-819-0069
Provider Business Practice Location Address
First Line : 6757 BURDEN LN
Second Line :
City : BATON ROUGE
State : LA
Zip : 70808-4212
Country : US
Telephone Number : 225-767-0940
Fax Number : 225-819-0069
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 07/08/2007

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