Healthcare Provider Details

I. General information

NPI: 1306928411
Provider Name (Legal Business Name): PAUL C KRAMM MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 03/08/2022
Certification Date: 03/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11406 LAKE SHERWOOD AVE N
BATON ROUGE LA
70816-0406
US

IV. Provider business mailing address

11406 LAKE SHERWOOD AVE N
BATON ROUGE LA
70816-0406
US

V. Phone/Fax

Practice location:
  • Phone: 225-757-5657
  • Fax:
Mailing address:
  • Phone: 225-757-5657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number11430R
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number11430R
License Number StateLA

VIII. Authorized Official

Name: PAUL KRAMM
Title or Position: PHYSICIAN/OWNER
Credential:
Phone: 225-757-5657