Roger D Craddock is a Periodontics in Memphis, Tennessee. Roger D Craddock practices all healthcare services and medical treatments related to Periodontics. The NPI Number for Roger D Craddock is 1114056694. The last update date is 2007-07-08.
Roger D Craddock's current location address is 6268 Poplar Ave, Memphis, Tennessee. You can contact this provider via phone number 9017613770 and fax number 9017613775. The mailing address for Roger D Craddock is 6268 Poplar Ave, Memphis, Tennessee. To know further, please read the information below!
Provider Profile Detail
Provider Name | Roger D Craddock |
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Address | 6268 Poplar Ave, Memphis, Tennessee |
Phone Number | 9017613770 |
Fax Number | 9017613775 |
Sole Proprietor | N |
Credentials | D.D.S. |
NPI Number Detail
NPI Number | 1114056694 |
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Provider Enumeration Date | 2007-03-02 |
Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
Address | 6268 Poplar Ave |
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City | Memphis |
State | Tennessee (TN) |
Post Code | 381194713 |
Phone Number | 9017613770 |
Fax Number | 9017613775 |
Provider's Primary Taxonomy Detail
Speciality | Periodontics |
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Taxonomy | 1223P0300X |
Licence No | 6912 |
Definition: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structure |
Post Comment/ Review Below
What is the unique identifier code issued to Roger D Craddock by the Centers for Medicare & Medicaid Services?
The Roger D Craddock has been assigned the NPI (National Provider Identifier) 1114056694. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Roger D Craddock's physical address?
The Roger D Craddock is physically located at 6268 Poplar Ave, in the city of Memphis, TN, with the postal code 381194713.
What is Roger D Craddock's specialized field of practice, and what is the corresponding taxonomy classification code?
The Roger D Craddock's area of specialization is Periodontics, and the corresponding taxonomy code that categorizes this field of practice is 1223P0300X.
On what date did the Roger D Craddock receive the assignment of its 1114056694 from the Centers for Medicare & Medicaid Services?
The Roger D Craddock was issued its 1114056694 by the Centers for Medicare & Medicaid Services on 2007-03-02.
When was the information regarding Roger D Craddock, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Roger D Craddock, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2007-07-08.
NPI Number: 1336142389
Address: Po Box 2004, East Syracuse, NY