Criddle, Charles Travis

Criddle, Charles Travis is an individual health care provider with primary practice located at 3277 E Louise Dr Suite 200, Meridian ID 83642-9351. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Criddle, Charles Travis can be contacted via phone (208) 468-5930.

Contact Information

Primary practice address
3277 E Louise Dr Suite 200 Meridian ID 83642-9351
Phone: (208) 468-5930
Fax: (208) 463-3044
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 125-051457 Illinois
Allopathic & Osteopathic Physicians / Pediatrics 208000000X O-0532 Idaho

Profile Details

NPI number 1366646150
LBN Legal business name Criddle, Charles Travis
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2007
Last updated Dec 18th, 2009 - about 15 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1366646150 NPPES
Idaho MEDICAID 8084089

Popular Providers