Provider Demographics
NPI:1801857982
Name:KEMP, DWIGHT T (DO)
Entity Type:Individual
Prefix:
First Name:DWIGHT
Middle Name:T
Last Name:KEMP
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 1:190 CAMPUS BLVD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2872
Mailing Address - Country:US
Mailing Address - Phone:540-667-9252
Mailing Address - Fax:540-722-4514
Practice Address - Street 1:190 CAMPUS BLVD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2872
Practice Address - Country:US
Practice Address - Phone:540-667-9252
Practice Address - Fax:540-722-4514
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102050240207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00284268OtherRAILROAD MEDICARE
WV3810003374Medicaid
VA010195641Medicaid
WV3810003374Medicaid