Healthcare Provider Details

I. General information

NPI: 1629052709
Provider Name (Legal Business Name): KATHI J KEMPER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2005
Last Update Date: 02/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 KENNY RD
COLUMBUS OH
43221-3502
US

IV. Provider business mailing address

2000 KENNY RD
COLUMBUS OH
43221-3502
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-9777
  • Fax: 614-293-9776
Mailing address:
  • Phone: 614-293-9777
  • Fax: 614-293-9776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number200101226
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35120656
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: