Healthcare Provider Details

I. General information

NPI: 1083042667
Provider Name (Legal Business Name): CRAIG M. DOXEY P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2013
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

691 E 400 N STE 110
VINEYARD UT
84059-7509
US

IV. Provider business mailing address

PO BOX 912042
ST GEORGE UT
84791-2042
US

V. Phone/Fax

Practice location:
  • Phone: 385-203-0246
  • Fax: 385-203-0245
Mailing address:
  • Phone: 385-203-0246
  • Fax: 385-203-0245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number12445726-1206
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: