Craddock, Duane Eldon

Craddock, Duane Eldon is an individual health care provider with primary practice located at 700 W Ironwood Dr Ste 155, Coeur D Alene ID 83814-2656. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Craddock, Duane Eldon can be contacted via phone (208) 667-0585.

Contact Information

Primary practice address
700 W Ironwood Dr Ste 155 Coeur D Alene ID 83814-2656
Phone: (208) 667-0585
Fax: (208) 667-0876
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X M7929 Idaho

Profile Details

NPI number 1609886514
LBN Legal business name Craddock, Duane Eldon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2006
Last updated Mar 8th, 2017 - about 9 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 1609886514 NPPES
Idaho Other J3995 BLUE CROSS OF IDAHO
Idaho Other 000010028256 BLUE CROSS OF IDAHO
Idaho Other 000010028257 BLUE CROSS OF IDAHO
Idaho MEDICAID 1609886514 BLUE CROSS OF IDAHO
Idaho MEDICAID 8267114 BLUE CROSS OF IDAHO
Idaho MEDICAID 805750600 BLUE CROSS OF IDAHO
Idaho Other J3953 BLUE CROSS OF IDAHO

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