Provider Demographics
NPI:1396289005
Name:CRAIG, CODI (PAC)
Entity type:Individual
Prefix:
First Name:CODI
Middle Name:
Last Name:CRAIG
Suffix:
Gender:F
Credentials:PAC
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Mailing Address - Street 1:1713 US HIGHWAY 441 N
Mailing Address - Street 2:SUITE H
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34972-1900
Mailing Address - Country:US
Mailing Address - Phone:863-357-1510
Mailing Address - Fax:863-357-1518
Practice Address - Street 1:1926 ALCOA HWY STE F210
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1545
Practice Address - Country:US
Practice Address - Phone:865-305-2495
Practice Address - Fax:865-305-2496
Is Sole Proprietor?:No
Enumeration Date:2016-12-14
Last Update Date:2025-09-02
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Provider Licenses
StateLicense IDTaxonomies
TNPA0000003122363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical