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General NPI Number Information
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NPI Number | 1578632501
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Entity Type | Organization
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Legal Business Name | PHYSICIAN ASSOCIATES OF KEMPER,INC
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 140 W KEMPER RD
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City | CINCINNATI
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State | OH
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Zip | 45246-2530
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Country | US
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Telephone | 513-671-2902
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Fax |
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Provider Business Mailing Address
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Address Line | 5770 KUGLER MILL ROAD
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City | CINCINNATI
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State | OH
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Zip | 45236-2040
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Country | US
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Telephone | 513-671-2902
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RADHIKA DONEPUDI
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Credential | M.D.
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Telephone | 513-671-2902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35071677D
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License Number State | OH
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