MEDICARE: MR. MARCIS A CRAIG 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	207X00000X	Orthopaedic Surgery Physician	37730	KY

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	:	1821080441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARCIS A CRAIG MD

Provider Business Mailing Address
First Line	:	1113 WOODLAND DR
Second Line	:
City	:	ELIZABETHTOWN
State	:	KY
Zip	:	42701-2749
Country	:	US
Telephone Number	:	270-737-4343
Fax Number	:	270-769-1072

Provider Business Practice Location Address
First Line	:	1113 WOODLAND DR
Second Line	:
City	:	ELIZABETHTOWN
State	:	KY
Zip	:	42701-2749
Country	:	US
Telephone Number	:	270-737-4343
Fax Number	:	270-769-1072

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

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	07/08/2007

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