Provider Demographics
NPI:1851461412
Name:KEMPLE, TIMOTHY D (DPM)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:D
Last Name:KEMPLE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-3113
Mailing Address - Country:US
Mailing Address - Phone:603-898-5864
Mailing Address - Fax:603-898-1207
Practice Address - Street 1:198 MAIN ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-3113
Practice Address - Country:US
Practice Address - Phone:603-898-5864
Practice Address - Fax:603-898-1207
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH204213E00000X
MA1854213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0308277Y0NH03OtherANTHEM
NHPRK020OtherHARVARD PILGRIM
NH30363927Medicaid
MAPRK020OtherHARVARD PILGRIM
MAPRK020OtherHARVARD PILGRIM
T25742Medicare UPIN