Provider Demographics
NPI:1427046077
Name:KRAMER, JAMES L (PA C)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:L
Last Name:KRAMER
Suffix:
Gender:M
Credentials:PA C
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Mailing Address - Street 1:445 E CHEYENNE MTN BLVD # E
Mailing Address - Street 2:PMB 406
Mailing Address - City:COLORADO SPGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-4570
Mailing Address - Country:US
Mailing Address - Phone:719-538-8100
Mailing Address - Fax:719-538-8003
Practice Address - Street 1:1008 MINNEGUA AVE
Practice Address - Street 2:EMERGENCY ROOM
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81004
Practice Address - Country:US
Practice Address - Phone:719-557-5656
Practice Address - Fax:719-557-4715
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2008-03-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
COPA 14363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO38125862Medicaid
970020140OtherRAILROAD MEDICARE
383718Medicare PIN
COS75869Medicare UPIN