Provider Demographics
NPI:1104862259
Name:CRAFT, BARBARA S (MD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:S
Last Name:CRAFT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 NORTH STATE STREET
Mailing Address - Street 2:DIVISION OF ONCOLOGY
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4500
Mailing Address - Country:US
Mailing Address - Phone:601-984-6426
Mailing Address - Fax:601-984-6439
Practice Address - Street 1:2500 NORTH STATE STREET
Practice Address - Street 2:DIVISION OF ONCOLOGY
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4500
Practice Address - Country:US
Practice Address - Phone:601-984-5590
Practice Address - Fax:601-984-5599
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS18263207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS08252334Medicaid
AL1104862259Medicaid
MSP01212509OtherRAILROAD MEDICARE
MS08252334Medicaid
MS302I907190Medicare PIN
MSP01212509OtherRAILROAD MEDICARE