Provider Demographics
NPI:1306918305
Name:KRAMER & NEWCOMB OD, PC
Entity type:Organization
Organization Name:KRAMER & NEWCOMB OD, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:417-345-2901
Mailing Address - Street 1:PO BOX 80
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:MO
Mailing Address - Zip Code:65622-0080
Mailing Address - Country:US
Mailing Address - Phone:417-345-2901
Mailing Address - Fax:417-345-2904
Practice Address - Street 1:112 W COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:MO
Practice Address - Zip Code:65622-7614
Practice Address - Country:US
Practice Address - Phone:417-345-2901
Practice Address - Fax:417-345-2904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0340870002Medicare NSC