Provider Demographics
NPI:1205828191
Name:CRAMER, JEFFERY A (OD)
Entity Type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:A
Last Name:CRAMER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 S KANSAS AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66612-1210
Mailing Address - Country:US
Mailing Address - Phone:785-234-6649
Mailing Address - Fax:785-234-6653
Practice Address - Street 1:927 S KANSAS AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66612-1210
Practice Address - Country:US
Practice Address - Phone:785-234-6649
Practice Address - Fax:785-234-6653
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1276-3152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100218520AMedicaid
KS0367290001Medicare NSC
KST71343Medicare UPIN
KST71343Medicare ID - Type Unspecified