Provider Demographics
NPI:1831127521
Name:KEMP, CARLTON R JR (MD)
Entity Type:Individual
Prefix:
First Name:CARLTON
Middle Name:R
Last Name:KEMP
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 WATERS AVE STE 507
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-6220
Mailing Address - Country:US
Mailing Address - Phone:912-350-4750
Mailing Address - Fax:912-350-4751
Practice Address - Street 1:4700 WATERS AVE STE 507
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-6220
Practice Address - Country:US
Practice Address - Phone:912-350-4750
Practice Address - Fax:912-350-4751
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA046870207RC0200X, 207RS0012X, 207RP1001X
FLME 100245207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA879204OtherBLUE CROSS BLUE SHIELD
582162071002OtherCHAMPUS
FL50026OtherBCBS
SCG46870Medicaid
P00053217OtherRAILROAD MEDICARE
GA352352957AMedicaid
GA11BDWWGMedicare PIN
SCG46870Medicaid
GA879204OtherBLUE CROSS BLUE SHIELD