Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 14243 | MS |
NPI | 1396814794 |
---|---|
Provider Name | James J Kramer |
First Address | Ridgeland, MS 39157-5228 |
Second Address | Ridgeland, MS 39157-5228 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A47306 | (02) | MS |