Provider Demographics
NPI:1841228525
Name:ZEMPOLICH, KAREN A (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:A
Last Name:ZEMPOLICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7181 S CAMPUS VIEW DR STE 200
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-4312
Mailing Address - Country:US
Mailing Address - Phone:801-965-3505
Mailing Address - Fax:
Practice Address - Street 1:348 E 4500 S STE 200
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-8509
Practice Address - Country:US
Practice Address - Phone:801-262-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-9133207VX0201X
UT277129-1205207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1053593921Medicaid
ID805900400Medicaid
WY1841228525Medicaid
ID807079100Medicaid
ID8L006OtherBLUE CROSS OF IDAHO
ID8L006OtherBLUE CROSS OF IDAHO
ID805900400Medicaid
P00466513Medicare PIN
P00699199Medicare PIN
ID1129058Medicare PIN