Craft, Randall O

Craft, Randall O is an individual health care provider with primary practice located at 6036 N 19Th Ave Ste 501 , Phoenix AZ 85015-2143. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery is his primary health care specialty. Craft, Randall O can be contacted via phone (602) 899-6444.

Contact Information

Primary practice address
6036 N 19Th Ave Ste 501 Phoenix AZ 85015-2143
Phone: (602) 899-6444
Fax: (602) 899-4161
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 33325 Arizona
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X 33325 Arizona

Profile Details

NPI number 1326079617
LBN Legal business name Craft, Randall O
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2006
Last updated Apr 16th, 2020 - about 4 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 1326079617 NPPES
Arizona MEDICAID 896607

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