Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | MD0000017906 | TN |
NPI | 1407995145 |
---|---|
Provider Name | Dr. William F. Craven |
First Address | Memphis, TN 38133-8191 |
Second Address | Memphis, TN 38133-8191 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A99583 | (02) | TN |