Basic Information
| Provider Information | |||||||||
| NPI: | 1699747170 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LABUDA | ||||||||
| FirstName: | CRAIG | ||||||||
| MiddleName: | STEVEN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 JARRETT WHITE RD | ||||||||
| Address2: | TRIPLER ARMY MEDICAL CENTER ATN: MCHK-QS | ||||||||
| City: | TRIPLER AMC | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968595001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8084332460 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4102 PINION DR | ||||||||
| Address2: | |||||||||
| City: | USAF ACADEMY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 808402502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195242273 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2006 | ||||||||
| LastUpdateDate: | 12/15/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | DR.0057205 | CO | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 4947 | AK | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.