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General NPI Number Information
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NPI Number | 1972890861
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Entity Type | Organization
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Legal Business Name | J. ANDREW KRAMER,O.D.,P.C.
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Dates
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Enumeration Date | 06/30/2011
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Last Update Date | 11/04/2016
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Provider Practice Location Address
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Address Line | 3901 S PROVIDENCE RD SUITE B
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City | COLUMBIA
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State | MO
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Zip | 65203-7174
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Country | US
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Telephone | 573-449-4188
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Fax | 573-443-2842
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Provider Business Mailing Address
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Address Line | 3901 S PROVIDENCE RD SUITE B
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City | COLUMBIA
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State | MO
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Zip | 65203-7174
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Country | US
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Telephone | 573-449-4188
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Fax | 573-443-2842
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES ANDREW KRAMER
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Credential | O.D.
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Telephone | 573-449-4188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TO2679
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License Number State | MO
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