Healthcare Provider Details

I. General information

NPI: 1184612491
Provider Name (Legal Business Name): RANDY L CRAMPTON DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: R L CRAMPTON DPM

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 01/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 W RAILROAD ST
STORM LAKE IA
50588-1404
US

IV. Provider business mailing address

PO BOX 1404
STORM LAKE IA
50588-1404
US

V. Phone/Fax

Practice location:
  • Phone: 712-732-6396
  • Fax: 712-732-9534
Mailing address:
  • Phone: 712-732-6396
  • Fax: 712-732-9534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number00340
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: