Basic Information
| Provider Information | |||||||||
| NPI: | 1225257553 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CRAFT | ||||||||
| FirstName: | YANCY | ||||||||
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| Credential: | MD, MPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 9178 | ||||||||
| Address2: | |||||||||
| City: | RUSSELLVILLE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 728119178 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4799684273 | ||||||||
| FaxNumber: | 4799681363 | ||||||||
| Practice Location | |||||||||
| Address1: | 2719 SE I ST | ||||||||
| Address2: | |||||||||
| City: | BENTONVILLE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 727123996 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4792735437 | ||||||||
| FaxNumber: | 4792739932 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2007 | ||||||||
| LastUpdateDate: | 07/06/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | E-6829 | AR | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.