Small, Craig K
Small, Craig K is an sole proprietor health care provider with primary practice located at 37 Herschel St , Caribou ME 04736-2426. He recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Corneal and Contact Management. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Small, Craig K can be contacted via phone (207) 496-5111.Contact Information
Primary practice address
37 Herschel St
Caribou ME 04736-2426
Phone: (207) 496-5111
Fax: (207) 498-6502
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPT736 | Maine |
| Eye and Vision Services Providers / Pediatrics | 152WP0200X | OPT736 | Maine |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | OPT736 | Maine |
Profile Details
| NPI number | 1134156144 |
|---|---|
| LBN Legal business name | Small, Craig K |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 26th, 2006 |
| Last updated | Feb 16th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134156144 | NPPES |
| Maine | Other | 010429521 | PROVIDER ID |
| Maine | Other | 0253910001 | PROVIDER ID |
| Maine | Other | P00071063 | PROVIDER ID |
| Maine | MEDICAID | 118340099 | PROVIDER ID |
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