Healthcare Provider Details

I. General information

NPI: 1336502111
Provider Name (Legal Business Name): SCOTT CRAIG MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2016
Last Update Date: 04/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 PHYSICIANS WAY
FRANKLIN TN
37067-1471
US

IV. Provider business mailing address

9634 MILLSFORD CT
BRENTWOOD TN
37027-8475
US

V. Phone/Fax

Practice location:
  • Phone: 630-715-9317
  • Fax: 615-721-4395
Mailing address:
  • Phone: 630-715-9317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberMD0000053297
License Number StateTN

VIII. Authorized Official

Name: MRS. CHRIS CRAIG
Title or Position: OFFICE MANAGER
Credential:
Phone: 630-715-9317