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General NPI Number Information
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NPI Number | 1518940964
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Entity Type | Individual
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Provider Name | STEPHEN A TRAMILL DO
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Gender | Male
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Dates
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Enumeration Date | 11/21/2005
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Last Update Date | 12/30/2016
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Provider Practice Location Address
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Address Line | 1451 N LAKELAND DR
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City | MERIDIAN
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State | MS
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Zip | 39307-9020
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Country | US
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Telephone | 601-581-8457
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Fax | 601-581-8464
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Provider Business Mailing Address
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Address Line | 105 INDIAN CREEK DR P. O. BOX 928
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City | NEWTON
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State | MS
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Zip | 39345-3101
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Country | US
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Telephone | 601-683-6342
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Fax | 601-683-7948
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 12207
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License Number State | MS
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