Healthcare Provider Details

I. General information

NPI: 1346247590
Provider Name (Legal Business Name): WILLIAM DILLON CRAVER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 NW MERCY DR SUITE 200
ROSEBURG OR
97470-2348
US

IV. Provider business mailing address

210 N TUSTIN AVE
SANTA ANA CA
92705-3807
US

V. Phone/Fax

Practice location:
  • Phone: 541-677-2800
  • Fax: 541-677-2820
Mailing address:
  • Phone: 800-883-7243
  • Fax: 714-647-1245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD14642
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: