Craddock, Jay Oliver

Craddock, Jay Oliver is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. He recently has only one registered license in Allopathic & Osteopathic Physicians / Glaucoma Specialist, which is considered as his primary health care specialty. Craddock, Jay Oliver can be contacted via phone (601) 984-5017.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 984-5017
Fax: (601) 984-5042
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Glaucoma Specialist 207WX0009X 22524 Mississippi

Profile Details

NPI number 1477865723
LBN Legal business name Craddock, Jay Oliver
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2010
Last updated Oct 8th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477865723 NPPES
Mississippi MEDICAID 01274279
Mississippi MEDICAID 2406647

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