William P Cravens, M.D.

Individual provider Active NPI Family Medicine Physician · Fulton, MO

NPI 1104802479 · NPPES record last updated Mar 11, 2015

Key facts

NPI
1104802479
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
R7F41 (MO)
Practice address
850 West Hospital Drive
Suite a
Fulton, MO 65251
Phone
(573) 592-0337
Fax
(573) 592-0711
NPI assigned
Dec 19, 2005
Sex
Male
Sole proprietor
No

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20031204000772 MO Practitioner - Family Practice
Practitioner - Internal Medicine
Practitioner - Emergency Medicine
1951206978 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians of Memphis LLC Emergency Medicine Current
since Sep 1, 2020
Accepting new patients
Camden Emergency Group LLC Emergency Medicine Current
since May 1, 2012
Accepting new patients
Callaway Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
Healthmont of Missouri LLC Past Accepting new patients

Locations

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R7F41 MO Yes
Emergency Medicine Physician 207P00000X R7F41 MO

Addresses

Primary practice location

850 West Hospital Drive
Suite a
Fulton, MO 65251

Mailing address

PO Box 6067
Fulton, MO 65251-6067
Phone (573) 592-0337

Other providers in Fulton, MO

All providers in Fulton, MO · Family Medicine Physician in Missouri

Sources for this page

Verify at the official NPI Registry.