Provider Demographics
NPI:1346350790
Name:ED P KEMPER, MD, PA
Entity Type:Organization
Organization Name:ED P KEMPER, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ED
Authorized Official - Middle Name:P
Authorized Official - Last Name:KEMPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:254-526-9939
Mailing Address - Street 1:PO BOX 938
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76540-0938
Mailing Address - Country:US
Mailing Address - Phone:254-634-6999
Mailing Address - Fax:254-200-4090
Practice Address - Street 1:2207 S CLEAR CREEK RD
Practice Address - Street 2:STE 201
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-4132
Practice Address - Country:US
Practice Address - Phone:254-526-9939
Practice Address - Fax:254-526-8906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E9085Medicare UPIN