Provider Demographics
NPI:1730218769
Name:DRS CURT E & CRAIG GRAMELSPACHER OD
Entity type:Organization
Organization Name:DRS CURT E & CRAIG GRAMELSPACHER OD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:J
Authorized Official - Last Name:GRAMELSPACHER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:812-482-1990
Mailing Address - Street 1:PO BOX 590
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47547-0590
Mailing Address - Country:US
Mailing Address - Phone:812-482-1990
Mailing Address - Fax:812-634-6845
Practice Address - Street 1:115 E 9TH ST
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-3010
Practice Address - Country:US
Practice Address - Phone:812-482-1990
Practice Address - Fax:812-634-6845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18001949B152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000382008OtherANTHEM CRAIG'S
IN410003940OtherRAILROAD MEDICARE ID
IN000000224633OtherANTHEM CURT'S
IN100109600AMedicaid
IN100109600AMedicaid
IN0452950001Medicare NSC
IN410003940OtherRAILROAD MEDICARE ID
IN211340Medicare PIN