Provider Demographics
NPI:1891950283
Name:GRAMLING, ROBERT E III (CRNA)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:E
Last Name:GRAMLING
Suffix:III
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 GREENBRIAR ST
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-4302
Mailing Address - Country:US
Mailing Address - Phone:601-408-4446
Mailing Address - Fax:
Practice Address - Street 1:1926 23RD AVE
Practice Address - Street 2:EAST MISSISSIPPI ENDOSCOPY CENTER
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-3107
Practice Address - Country:US
Practice Address - Phone:601-485-1131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR862292367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered