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NPI Code Detail

MEDICARE: DR. RONALD L CRAFTON MD

MEDICARE: DR. RONALD L CRAFTON 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
1207P00000XEmergency Medicine Physician30056KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
230056OTHERKYKENTUCKY LICENSE
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619923802
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RONALD L CRAFTON MD
Provider Business Mailing Address
First Line : PO BOX 950248
Second Line :
City : LOUISVILLE
State : KY
Zip : 40295-0248
Country : US
Telephone Number : 502-253-1035
Fax Number : 502-253-1037
Provider Business Practice Location Address
First Line : 1025 NEW MOODY LN
Second Line :
City : LA GRANGE
State : KY
Zip : 40031-9154
Country : US
Telephone Number : 502-222-3347
Fax Number : 502-222-3634
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2006
Last Update Date : 03/07/2023

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