Provider Demographics
NPI:1205844024
Name:KRAMER, ANDREW PHILLIP (DO)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:PHILLIP
Last Name:KRAMER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 CLINCHFIELD STREET
Mailing Address - Street 2:SUITE 2900
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660
Mailing Address - Country:US
Mailing Address - Phone:423-245-6101
Mailing Address - Fax:423-245-2396
Practice Address - Street 1:444 CLINCHFIELD STREET
Practice Address - Street 2:SUITE 2900
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660
Practice Address - Country:US
Practice Address - Phone:423-245-6101
Practice Address - Fax:423-245-2396
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO0000001662208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4141643OtherBLUE CROSS TENNESSEE
VA270767OtherBLUE CROSS ANTHEM VIRGINI
VA010389607Medicaid
TN3319974Medicare ID - Type Unspecified