Provider Demographics
NPI:1326038746
Name:WEMPE, JOHN MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:MICHAEL
Last Name:WEMPE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:17880 PIONEER XING
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80908-1452
Mailing Address - Country:US
Mailing Address - Phone:719-694-8075
Mailing Address - Fax:
Practice Address - Street 1:1650 COCHRANE CIRCLE BLDG 75, SFCC, ADMIN. BUILDING QSD
Practice Address - Street 2:USA MEDDAC, EVANS ACH
Practice Address - City:FORT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913
Practice Address - Country:US
Practice Address - Phone:719-526-1523
Practice Address - Fax:719-526-7732
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01048126A2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYVAD000Medicare UPIN