Provider Demographics
NPI:1407848351
Name:KRAMER, PAUL L (DO)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:L
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 1:1500 STATE STREET
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:64067-1107
Mailing Address - Country:US
Mailing Address - Phone:660-259-2203
Mailing Address - Fax:660-259-6813
Practice Address - Street 1:1500 STATE STREET
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MO
Practice Address - Zip Code:64067-1107
Practice Address - Country:US
Practice Address - Phone:660-259-2203
Practice Address - Fax:660-259-6813
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003009748207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO010568509Medicaid
MO540568508Medicaid
34780019OtherTRICARE
MO208753608Medicaid
KS90036022Medicaid
01089068OtherBCBS MO
MO32632021OtherBCBS MO
P270000Medicare PIN
H56549Medicare UPIN
KS90036022Medicaid
P27C431Medicare PIN
261320Medicare PIN
DA4239Medicare PIN