MEDICARE: RANDY L CRAMPTON DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	00340	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14143	OTHER	IA	WELLMARK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184612491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDY L CRAMPTON DPM

Provider Business Mailing Address
First Line	:	PO BOX 1404
Second Line	:
City	:	STORM LAKE
State	:	IA
Zip	:	50588-1404
Country	:	US
Telephone Number	:	712-732-6396
Fax Number	:	712-732-9534

Provider Business Practice Location Address
First Line	:	415 W RAILROAD ST
Second Line	:
City	:	STORM LAKE
State	:	IA
Zip	:	50588-1404
Country	:	US
Telephone Number	:	712-732-6396
Fax Number	:	712-732-9534

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	01/18/2019

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