Healthcare Provider Details

I. General information

NPI: 1447575469
Provider Name (Legal Business Name): JOHN PAUL KAMPA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2010
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 E STATE ST
SAINT CROIX FALLS WI
54024-4117
US

IV. Provider business mailing address

235 E STATE ST
SAINT CROIX FALLS WI
54024-4117
US

V. Phone/Fax

Practice location:
  • Phone: 715-483-3221
  • Fax: 715-483-0539
Mailing address:
  • Phone: 715-483-3221
  • Fax: 715-483-0539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number58792
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number58792
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number73345
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number58792
License Number StateMN
# 5
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number73345
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: