Healthcare Provider Details

I. General information

NPI: 1780146068
Provider Name (Legal Business Name): DARRYL S KEMP JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2019
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 S CASCADE ST
FERGUS FALLS MN
56537-2913
US

IV. Provider business mailing address

712 S CASCADE ST
FERGUS FALLS MN
56537-2913
US

V. Phone/Fax

Practice location:
  • Phone: 218-736-8000
  • Fax:
Mailing address:
  • Phone: 218-736-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number83765
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number83765
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: