Healthcare Provider Details

I. General information

NPI: 1629090931
Provider Name (Legal Business Name): JEFFREY W KEMPE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 08/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 ROYAL BIRKDALE DR SUITE A
COLUMBIANA OH
44408
US

IV. Provider business mailing address

9471 MARKET ST STE B
NORTH LIMA OH
44452-8702
US

V. Phone/Fax

Practice location:
  • Phone: 330-482-9350
  • Fax: 330-482-5695
Mailing address:
  • Phone: 330-729-2388
  • Fax: 330-629-6468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35-087355
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: