Provider Demographics
NPI:1326005547
Name:KEMPER, CHARLES (MPC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:
Last Name:KEMPER
Suffix:
Gender:M
Credentials:MPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1507 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-2939
Mailing Address - Country:US
Mailing Address - Phone:812-282-3772
Mailing Address - Fax:812-282-8577
Practice Address - Street 1:1507 SPRING ST
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130
Practice Address - Country:US
Practice Address - Phone:812-282-3772
Practice Address - Fax:812-282-8577
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01026928B207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100074880AMedicaid
IN121980Medicare ID - Type Unspecified
ING13073Medicare UPIN