Provider Demographics
NPI:1245587724
Name:KEMMERER, THOMAS (OD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:KEMMERER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16477 DELLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-2576
Mailing Address - Country:US
Mailing Address - Phone:515-505-0228
Mailing Address - Fax:
Practice Address - Street 1:3800 MERLE HAY RD STE 407
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-1323
Practice Address - Country:US
Practice Address - Phone:515-278-1653
Practice Address - Fax:515-278-0043
Is Sole Proprietor?:No
Enumeration Date:2012-08-14
Last Update Date:2020-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002614152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist