Provider Demographics
NPI:1518940964
Name:TRAMILL, STEPHEN A (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:A
Last Name:TRAMILL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:105 INDIAN CREEK DR
Mailing Address - Street 2:P. O. BOX 928
Mailing Address - City:NEWTON
Mailing Address - State:MS
Mailing Address - Zip Code:39345-3101
Mailing Address - Country:US
Mailing Address - Phone:601-683-6342
Mailing Address - Fax:601-683-7948
Practice Address - Street 1:1451 N LAKELAND DR
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39307-9020
Practice Address - Country:US
Practice Address - Phone:601-581-8457
Practice Address - Fax:601-581-8464
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-21
Last Update Date:2016-12-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MS12207207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00120122Medicaid
MS080002934Medicare Oscar/Certification
MSE42228Medicare UPIN