Healthcare Provider Details

I. General information

NPI: 1285069500
Provider Name (Legal Business Name): ROBERT GARY KRAMER III DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2013
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 N PORTER AVE
NORMAN OK
73071-6404
US

IV. Provider business mailing address

3220 SW 96TH ST
OKLAHOMA CITY OK
73159-6505
US

V. Phone/Fax

Practice location:
  • Phone: 405-307-1561
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number63898
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0369R
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: