Healthcare Provider Details

I. General information

NPI: 1386614311
Provider Name (Legal Business Name): CRAIG D CAMERON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W HOSPITAL RD ORTHOPAEDIC SURGERY CLINIC
FORT GORDON GA
30905-5741
US

IV. Provider business mailing address

300 EAST HOSPITAL ROAD ORTHOPAEDIC SURGERY CLINIC
FORT GORDON GA
30905-5650
US

V. Phone/Fax

Practice location:
  • Phone: 706-787-2300
  • Fax: 706-787-8176
Mailing address:
  • Phone: 706-787-2300
  • Fax: 706-787-8176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberK3694
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number72570
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: