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DR. DUANE ELDON CRADDOCK MD NPI 1609886514


NPI Information

NPI: 1609886514
Provider Name: DR. DUANE ELDON CRADDOCK, MD
Classification: Pediatrics - 208000000X
Entity Type: Individual
Address:
700 W IRONWOOD DR
STE 155
COEUR D ALENE, ID
ZIP 83814
Phone: (208) 667-0585
Get Directions

DR. Duane Eldon Craddock, MD is a pediatrics in Coeur D Alene, ID. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DR. Duane Eldon Craddock, MD NPI is 1609886514. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

700 W IRONWOOD DR
STE 155
COEUR D ALENE, ID
ZIP 83814-656
Phone: (208) 667-0585
Fax: (208) 667-0876

The enumeration date for this NPI number is 8/9/2006 and was last updated on 3/8/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsM7929IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11609886514MEDICAIDMONTANA
2000010028257OTHERIDAHOREGENCE BLUE SHIELD
31144200MEDICARE ID-TYPE UNSPECIFIED
4805750600MEDICAIDIDAHO
5000010028256OTHERIDAHOREGENCE BLUE SHIELD
6J3953OTHERIDAHOBLUE CROSS OF IDAHO
7H22757MEDICARE UPINIDAHO
88267114MEDICAIDWASHINGTON
9J3995OTHERIDAHOBLUE CROSS OF IDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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