MEDICARE: CRAIG VINCENT PAIGE P.A.-C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant
2	363A00000X	Physician Assistant	PA05714	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346344041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRAIG VINCENT PAIGE P.A.-C.

Provider Business Mailing Address
First Line	:	4301 MOW-WAY ROAD
Second Line	:	REYNOLDS ARMY COMMUNITY HOSPITAL (ATTN: MS. PRESCOTT)
City	:	FT. SILL
State	:	OK
Zip	:	73503-6300
Country	:	US
Telephone Number	:	580-458-2134
Fax Number	:	580-458-2314

Provider Business Practice Location Address
First Line	:	4301 MOW-WAY ROAD
Second Line	:	REYNOLDS ARMY COMMUNITY HOSPITAL (ATTN: MS. PRESCOTT)
City	:	FT. SILL
State	:	OK
Zip	:	73503-6300
Country	:	US
Telephone Number	:	580-458-2134
Fax Number	:	580-458-2314

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2006
Last Update Date	:	10/24/2011

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Directions to “ CRAIG VINCENT PAIGE P.A.-C.” Practice Location

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