MEDICARE: DR. JEFFREY ALAN KEMPF O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2003002151	MO
2	152W00000X	Optometrist	046009391	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386604411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY ALAN KEMPF O.D.

Provider Business Mailing Address
First Line	:	6451 CHIPPEWA ST
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63109-2104
Country	:	US
Telephone Number	:	314-353-6171
Fax Number	:	314-353-0031

Provider Business Practice Location Address
First Line	:	6451 CHIPPEWA ST
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63109-2104
Country	:	US
Telephone Number	:	314-353-6171
Fax Number	:	314-353-0031

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	10/23/2024

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