Provider Demographics
NPI:1578698429
Name:KEMEN, FREDERICK WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:WILLIAM
Last Name:KEMEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:KENTUCKY STATE REFORMATORY
Mailing Address - Street 2:3001 W. HIGHWAY 146
Mailing Address - City:LAGRANGE
Mailing Address - State:KY
Mailing Address - Zip Code:40032-0002
Mailing Address - Country:US
Mailing Address - Phone:502-222-9441
Mailing Address - Fax:502-225-0693
Practice Address - Street 1:KENTUCKY STATE REFORMATORY
Practice Address - Street 2:3001 W. HIGHWAY 146
Practice Address - City:LAGRANGE
Practice Address - State:KY
Practice Address - Zip Code:40032-0002
Practice Address - Country:US
Practice Address - Phone:502-222-9441
Practice Address - Fax:502-225-0693
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY29636207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine