Provider Demographics
NPI:1487926218
Name:CRADDICK, STEVEN LEE (PA-C, MPAS)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:LEE
Last Name:CRADDICK
Suffix:
Gender:M
Credentials:PA-C, MPAS
Other - Prefix:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1867 AIRPORT FRONTAGE ROAD
Mailing Address - Street 2:SUITE B (U.S. HEALTHWORKS ALASKA)
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-1867
Mailing Address - Country:US
Mailing Address - Phone:907-452-2178
Mailing Address - Fax:907-452-3178
Practice Address - Street 1:1867 AIRPORT FRONTAGE ROAD
Practice Address - Street 2:SUITE B (U.S. HEALTHWORKS ALASKA)
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-1867
Practice Address - Country:US
Practice Address - Phone:907-452-2178
Practice Address - Fax:907-452-3178
Is Sole Proprietor?:No
Enumeration Date:2012-02-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AK250363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK250OtherSTATE PA LICENSE NUMBER
AK250OtherSTATE PA LICENSE NUMBER