| James Michael Craven, MD | |
|
1050 W Granada Blvd, Suite 4, Ormond Beach, FL 32174-8154 | |
| (386) 677-8808 | |
| (386) 677-2134 |
| Full Name | James Michael Craven |
|---|---|
| Gender | Male |
| Speciality | Otolaryngology |
| Location | 1050 W Granada Blvd, Ormond Beach, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093749350 | NPI | - | NPPES |
| 040016956 | Other | GA | RR MEDICARE PIN |
| 37903705 | Other | KY | MEDICAID LAB GROUP |
| CB5773 | Other | GA | RR MEDICARE GROUP |
| 4000501 | Other | KY | MEDICARE LAB GROUP |
| 64047475 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Y00000X | Otolaryngology | 25633 (Kentucky) | Primary |
| 207YP0228X | Otolaryngology - Pediatric Otolaryngology | 25633 (Kentucky) | Secondary |
| Entity Name | Coastal Ear Nose & Throat Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1265417729 PECOS PAC ID: 7911083696 Enrollment ID: O20080320000299 |
| Mailing Address | Practice Location Address |
|---|---|
| James Michael Craven, MD 1050 W Granada Blvd, Suite 4, Ormond Beach, FL 32174-8154 Ph: (386) 677-8808 | James Michael Craven, MD 1050 W Granada Blvd, Suite 4, Ormond Beach, FL 32174-8154 Ph: (386) 677-8808 |
Dr. Perrin C Clark, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1050 W Granada Blvd, Suite 4, Ormond Beach, FL 32174 Phone: 386-677-8808 Fax: 386-677-9919 | |
Dr. Jane T Dillon, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1050 W Granada Blvd Ste 4, Ormond Beach, FL 32174 Phone: 386-677-8808 Fax: 386-677-9919 |