Provider Demographics
NPI:1265729073
Name:KRAMER, KATHRYN MELTON (OD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MELTON
Last Name:KRAMER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:MELTON
Other - Last Name:SHEPERD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:431 W 1ST AVE
Mailing Address - Street 2:APT 205
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-3518
Mailing Address - Country:US
Mailing Address - Phone:330-620-6024
Mailing Address - Fax:
Practice Address - Street 1:881 W 3RD AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-3106
Practice Address - Country:US
Practice Address - Phone:614-291-9400
Practice Address - Fax:614-291-9401
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6073152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist