Craddock, Durrett

Craddock, Durrett is an individual health care provider with primary practice located at 200 E Chestnut St , Louisville KY 40202-1831. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Craddock, Durrett can be contacted via phone (502) 629-7601.

Contact Information

Primary practice address
200 E Chestnut St Louisville KY 40202-1831
Phone: (502) 629-7601
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 01058855A Kentucky

Profile Details

NPI number 1700884137
LBN Legal business name Craddock, Durrett
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2005
Last updated Feb 27th, 2008 - about 18 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 1700884137 NPPES
Kentucky Other 000000308613 BC BS
Kentucky Other 50005977 BC BS
Kentucky Other 000000330651 BC BS
Kentucky MEDICAID 64054075 BC BS

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