Provider Demographics
NPI:1902239486
Name:KRAMER, AUSTIN ALAN (DPM)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:ALAN
Last Name:KRAMER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11233
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-0055
Mailing Address - Country:US
Mailing Address - Phone:479-587-0171
Mailing Address - Fax:479-587-0885
Practice Address - Street 1:509 E MILLSAP RD STE 101
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4862
Practice Address - Country:US
Practice Address - Phone:479-587-0171
Practice Address - Fax:479-587-0885
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-19
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR286213E00000X
FLPO3828213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist