Healthcare Provider Details

I. General information

NPI: 1407848351
Provider Name (Legal Business Name): PAUL L KRAMER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 05/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 STATE STREET
LEXINGTON MO
64067-1107
US

IV. Provider business mailing address

1500 STATE STREET
LEXINGTON MO
64067-1107
US

V. Phone/Fax

Practice location:
  • Phone: 660-259-2203
  • Fax: 660-259-6813
Mailing address:
  • Phone: 660-259-2203
  • Fax: 660-259-6813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2003009748
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: