Provider Demographics
NPI:1427344910
Name:BRAMON, JONI RUTH (DO)
Entity type:Individual
Prefix:
First Name:JONI
Middle Name:RUTH
Last Name:BRAMON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 W BUSINESS LOOP 70 STE 275
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-2522
Mailing Address - Country:US
Mailing Address - Phone:573-874-0008
Mailing Address - Fax:573-875-5350
Practice Address - Street 1:1001 W WORLEY ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-2037
Practice Address - Country:US
Practice Address - Phone:573-214-2314
Practice Address - Fax:573-814-2835
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2021-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS12783207Q00000X
MO2011017042207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012231800Medicaid
FL012231800Medicaid