Organization
JERALD N KRAMER DPM PC
Active
Other names
Podiatric SurgiCenter
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERALD N KRAMER DPM (MEDICAL DIRECTOR)
(404) 373-2529
Entity
Organization
Contact information
Practice address
215 CLAIREMONT AVE, DECATUR, GA 30030-2505
(404) 373-2529
(404) 373-1655
Mailing address
215 CLAIREMONT AVE, DECATUR, GA 30030-2505
(404) 373-2529
(404) 373-1655
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
044-074
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00561657A
MEDICAID PROVIDER NUMBER
GA
01
—
111050ASCA
MEDICARE PROVIDER NUMBER
GA
01
—
1881879559
PODIATRIC SURGICENTER
GA
Enumeration date
12/31/2007
Last updated
06/27/2008
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