Provider Demographics
NPI:1003051806
Name:KRAMER & NEWCOMB O.D., P.C.
Entity Type:Organization
Organization Name:KRAMER & NEWCOMB O.D., P.C.
Other - Org Name:MARSHFIELD EYE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
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 289
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65706-0289
Mailing Address - Country:US
Mailing Address - Phone:417-468-6682
Mailing Address - Fax:417-859-6634
Practice Address - Street 1:1350 SPUR DR
Practice Address - Street 2:SUITE 150
Practice Address - City:MARSHFIELD
Practice Address - State:MO
Practice Address - Zip Code:65706-2344
Practice Address - Country:US
Practice Address - Phone:417-468-6682
Practice Address - Fax:417-859-6634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0340870001Medicare NSC