Provider Demographics
NPI:1407890015
Name:KEMBRO, RONALD J (DO)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:J
Last Name:KEMBRO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 E MITCHELL ST
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2636
Mailing Address - Country:US
Mailing Address - Phone:915-920-3066
Mailing Address - Fax:
Practice Address - Street 1:650 JOEL DR
Practice Address - Street 2:ATTN: GENERAL SURGERY
Practice Address - City:FORT CAMPBELL
Practice Address - State:KY
Practice Address - Zip Code:42223-5318
Practice Address - Country:US
Practice Address - Phone:270-956-2134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO.2452207RC0200X
171000000X
NE4882086S0102X
TN25482086S0102X
VA01022037022086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No171000000XOther Service ProvidersMilitary Health Care Provider