Provider Demographics
NPI:1629066287
Name:DAVIS-KRAMER, BECKY J (DO)
Entity Type:Individual
Prefix:DR
First Name:BECKY
Middle Name:J
Last Name:DAVIS-KRAMER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:BECKY
Other - Middle Name:J
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1111 DUFF AVE
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-5793
Mailing Address - Country:US
Mailing Address - Phone:515-239-2155
Mailing Address - Fax:515-239-2050
Practice Address - Street 1:1111 DUFF AVE
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-5793
Practice Address - Country:US
Practice Address - Phone:515-239-2155
Practice Address - Fax:515-239-2050
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02308207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA5053728Medicaid
IA5053728Medicaid
IAE06897Medicare UPIN