Provider Demographics
NPI:1699702969
Name:DINGER, CRAIG P (MD)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:P
Last Name:DINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12 E APPLEBY
Mailing Address - Street 2:CLINIC ADMINISTRATION
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704
Mailing Address - Country:US
Mailing Address - Phone:479-463-1704
Mailing Address - Fax:479-463-7864
Practice Address - Street 1:146 A PASSION PLAY ROAD
Practice Address - Street 2:
Practice Address - City:EUREKA SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72632
Practice Address - Country:US
Practice Address - Phone:479-253-9746
Practice Address - Fax:479-253-2464
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI41570207Q00000X
ART2009-077207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32598100Medicaid
WIC92521Medicare UPIN
WI32598100Medicaid