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General NPI Number Information
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NPI Number | 1700046422
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Entity Type | Individual
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Provider Name | RANDALL G. CRAIG MD
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Gender | Male
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Dates
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Enumeration Date | 06/16/2008
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Last Update Date | 07/28/2020
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Provider Practice Location Address
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Address Line | 910 S HILLSIDE ST
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City | WICHITA
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State | KS
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Zip | 67211-4001
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Country | US
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Telephone | 316-247-2095
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Fax | 316-330-3900
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Provider Business Mailing Address
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Address Line | 3800 YORK ST
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City | DENVER
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State | CO
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Zip | 80205-3540
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Country | US
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Telephone | 720-833-5014
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Fax | 720-833-5072
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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 | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | G9084
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 30917
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License Number State | CO
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