Packham, Craig Aaron

Packham, Craig Aaron is an individual health care provider with primary practice located at 2356 N 400 E Ste 102, Tooele UT 84074. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Packham, Craig Aaron can be contacted via phone (435) 833-9180.

Contact Information

Primary practice address
2356 N 400 E Ste 102 Tooele UT 84074
Phone: (435) 833-9180
Fax: (435) 833-9177
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 51058218002 Utah

Profile Details

NPI number 1104920354
LBN Legal business name Packham, Craig Aaron
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 9th, 2006
Last updated Jul 15th, 2019 - about 5 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 1104920354 NPPES
Utah MEDICAID D4703

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