Healthcare Provider Details

I. General information

NPI: 1023055746
Provider Name (Legal Business Name): DAVID D CRAVENS MD, MSPH, CMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 05/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE HOSPITAL DRIVE
COLUMBIA MO
65201-0001
US

IV. Provider business mailing address

PO BOX 843966
KANSAS CITY MO
64184-3966
US

V. Phone/Fax

Practice location:
  • Phone: 573-884-7733
  • Fax: 573-884-5559
Mailing address:
  • Phone: 573-884-3300
  • Fax: 573-884-0943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR9438
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberR9438
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: