Provider Demographics
NPI:1972187466
Name:KEMPTON, JAY CALVIN
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:CALVIN
Last Name:KEMPTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1291 E WOOLFORD RD LOT B
Mailing Address - Street 2:
Mailing Address - City:SHOW LOW
Mailing Address - State:AZ
Mailing Address - Zip Code:85901-7118
Mailing Address - Country:US
Mailing Address - Phone:928-322-4227
Mailing Address - Fax:
Practice Address - Street 1:5300 S SUTTER DR STE A
Practice Address - Street 2:
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901-8054
Practice Address - Country:US
Practice Address - Phone:928-251-4244
Practice Address - Fax:833-539-1739
Is Sole Proprietor?:No
Enumeration Date:2021-05-10
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ250964207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine