MEDICARE: CRAIG W FURRY 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
1	261QR1300X	Rural Health Clinic/Center
2	207Q00000X	Family Medicine Physician	036067057	IL
3	207P00000X	Emergency Medicine Physician	036067057	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	744481	OTHER	IL	MEDICARE NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	P00173490	OTHER	IL	IND # FOR NCP SO ILLINOIS

General Provider Information

NPI Number	:	1609864750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRAIG W FURRY MD

Provider Business Mailing Address
First Line	:	PO BOX 1080
Second Line	:
City	:	DU QUOIN
State	:	IL
Zip	:	62832-5080
Country	:	US
Telephone Number	:	618-542-2129
Fax Number	:	618-542-2903

Provider Business Practice Location Address
First Line	:	20 N WASHINGTON ST
Second Line	:	SUITE 2
City	:	DU QUOIN
State	:	IL
Zip	:	62832-1403
Country	:	US
Telephone Number	:	618-542-2129
Fax Number	:	618-542-2903

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

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	02/08/2017

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Directions to “ CRAIG W FURRY MD” Practice Location

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