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General NPI Number Information
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NPI Number | 1578566766
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Entity Type | Individual
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Provider Name | CRAIG CLAYTON CARTIA MD
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Gender | Male
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 11/08/2019
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Provider Practice Location Address
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Address Line | 106 BELINDA BLVD
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City | DANVILLE
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State | KY
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Zip | 40422-3217
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Country | US
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Telephone | 859-439-0340
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Fax | 859-209-4278
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Provider Business Mailing Address
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Address Line | PO BOX 73652
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City | CLEVELAND
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State | OH
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Zip | 44193-0002
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Country | US
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Telephone | 859-313-2758
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LA0401X
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Taxonomy Name | Addiction Medicine (Anesthesiology) Physician
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License Number | 32838
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License Number State | KY
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