Provider Demographics
NPI:1760575187
Name:KRAMER, JAMES ANDREW (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ANDREW
Last Name:KRAMER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 S PROVIDENCE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-7174
Mailing Address - Country:US
Mailing Address - Phone:573-449-4188
Mailing Address - Fax:573-443-2842
Practice Address - Street 1:3901 S PROVIDENCE RD
Practice Address - Street 2:SUITE B
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-7174
Practice Address - Country:US
Practice Address - Phone:573-449-4188
Practice Address - Fax:573-443-2842
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-30
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOTO2679152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOT42797Medicare UPIN
MOMA3460001Medicare PIN
MOMA3460Medicare PIN
MO000008050Medicare ID - Type Unspecified
MO1972890861Medicare PIN