Provider Demographics
NPI:1548664519
Name:ALLEN CRAIG AU D INC
Entity type:Organization
Organization Name:ALLEN CRAIG AU D INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:AU D
Authorized Official - Phone:870-268-1488
Mailing Address - Street 1:820 E MATTHEWS AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-3048
Mailing Address - Country:US
Mailing Address - Phone:870-268-1488
Mailing Address - Fax:870-268-1613
Practice Address - Street 1:820 E MATTHEWS AVE
Practice Address - Street 2:SUITE A
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-3048
Practice Address - Country:US
Practice Address - Phone:870-268-1488
Practice Address - Fax:870-268-1613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-20
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA189261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech