Provider Demographics
NPI:1285803452
Name:STEVEN E. CRAIG
Entity type:Organization
Organization Name:STEVEN E. CRAIG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:563-242-5763
Mailing Address - Street 1:2745 LINCOLN WAY
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-7201
Mailing Address - Country:US
Mailing Address - Phone:563-242-5763
Mailing Address - Fax:563-242-3922
Practice Address - Street 1:2745 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-7201
Practice Address - Country:US
Practice Address - Phone:563-242-5763
Practice Address - Fax:563-242-3922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00660332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1225150001Medicare NSC