Craddock, Teresa M

Craddock, Teresa M is an individual health care provider with primary practice located at 1515 S Clifton Ave Ste 400, Wichita KS 67218-2900. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Craddock, Teresa M can be contacted via phone (316) 636-1550.

Contact Information

Primary practice address
1515 S Clifton Ave Ste 400 Wichita KS 67218-2900
Phone: (316) 636-1550
Fax: (316) 689-9769
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 0425326 Kansas

Profile Details

NPI number 1811949241
LBN Legal business name Craddock, Teresa M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2006
Last updated Jan 31st, 2014 - about 11 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 1811949241 NPPES
Oklahoma Other 100285040N OK MEDICAID
Oklahoma MEDICAID 100285040N OK MEDICAID
Oklahoma Other 016576028 OK MEDICAID

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