Provider Demographics
NPI:1588712038
Name:CRAIG, PATRICK (DC)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:CRAIG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8481 FISHERS CENTER DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-2318
Mailing Address - Country:US
Mailing Address - Phone:317-770-2384
Mailing Address - Fax:
Practice Address - Street 1:8481 FISHERS CENTER DR
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2318
Practice Address - Country:US
Practice Address - Phone:317-576-9620
Practice Address - Fax:317-576-9621
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001844A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
161050BMedicare ID - Type Unspecified
U81211Medicare UPIN