Healthcare Provider Details

I. General information

NPI: 1053575563
Provider Name (Legal Business Name): CRAIG A HURST MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2008
Last Update Date: 06/30/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6861 N ORACLE RD STE 22-24
TUCSON AZ
85704-4222
US

IV. Provider business mailing address

PO BOX 13627
TUCSON AZ
85732-3627
US

V. Phone/Fax

Practice location:
  • Phone: 520-770-8669
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number38238
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: