Healthcare Provider Details

I. General information

NPI: 1427072859
Provider Name (Legal Business Name): MICHAEL M. KEMPTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 05/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 E MAIN ST
CHARLESTON MS
38921-2414
US

IV. Provider business mailing address

423 E MAIN ST
CHARLESTON MS
38921-2414
US

V. Phone/Fax

Practice location:
  • Phone: 270-519-6435
  • Fax:
Mailing address:
  • Phone: 270-519-6435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number19940
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0000024301
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: