Provider Demographics
NPI:1780651562
Name:KRAMER-OLDROYD, KACI M (OD)
Entity type:Individual
Prefix:DR
First Name:KACI
Middle Name:M
Last Name:KRAMER-OLDROYD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18325 N ALLIED WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85054-3105
Mailing Address - Country:US
Mailing Address - Phone:602-467-4966
Mailing Address - Fax:480-419-5401
Practice Address - Street 1:18325 N ALLIED WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85054-3105
Practice Address - Country:US
Practice Address - Phone:602-467-4966
Practice Address - Fax:480-419-5401
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1152152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ368789Medicaid
AZ368789Medicaid
AZ67835Medicare ID - Type Unspecified