Provider Demographics
NPI:1063474427
Name:GERNON, CRAIG F (MD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:F
Last Name:GERNON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:929 SW MULVANE ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1677
Mailing Address - Country:US
Mailing Address - Phone:785-270-4100
Mailing Address - Fax:785-270-4177
Practice Address - Street 1:929 SW MULVANE ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1677
Practice Address - Country:US
Practice Address - Phone:785-270-4100
Practice Address - Fax:785-270-4177
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-30067207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100458320AMedicaid
KS100458320AMedicaid
G55552Medicare UPIN