Provider Demographics
NPI:1851383392
Name:DEMPSEY, HERBERT ALEXANDER (MD)
Entity Type:Individual
Prefix:
First Name:HERBERT
Middle Name:ALEXANDER
Last Name:DEMPSEY
Suffix:
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 1:806 NE CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-5427
Mailing Address - Country:US
Mailing Address - Phone:816-524-6142
Mailing Address - Fax:
Practice Address - Street 1:615 SW 3RD ST
Practice Address - Street 2:LEES SUMMIT CLINIC INC
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-2212
Practice Address - Country:US
Practice Address - Phone:816-524-3799
Practice Address - Fax:816-524-3921
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMD29670207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0080461Medicare ID - Type Unspecified
C50648Medicare UPIN