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NPI Code Detail

MEDICARE: CRAIG STAGG MD

MEDICARE: CRAIG STAGG MD
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
12083P0500XPreventive Medicine/Occupational Environmental Medicine PhysicianDR37193CO
22083P0500XPreventive Medicine/Occupational Environmental Medicine PhysicianM-16854ID

General Provider Information

NPI Number : 1568670842
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRAIG STAGG MD
Provider Business Mailing Address
First Line : 3340 E GOLDSTONE DR
Second Line :
City : MERIDIAN
State : ID
Zip : 83642-1026
Country : US
Telephone Number : 208-367-5170
Fax Number : 208-367-5180
Provider Business Practice Location Address
First Line : 1150 N SISTER CATHERINE WAY
Second Line :
City : NAMPA
State : ID
Zip : 83687-3133
Country : US
Telephone Number : 208-302-7640
Fax Number : 208-302-7625
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2007
Last Update Date : 10/31/2022

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Directions to “ CRAIG STAGG MD” Practice Location

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