Provider Demographics
NPI:1750371969
Name:KEMPARAJURS, PLAVAKEERTHI (MD)
Entity type:Individual
Prefix:
First Name:PLAVAKEERTHI
Middle Name:
Last Name:KEMPARAJURS
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:PO BOX 25
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:KY
Mailing Address - Zip Code:40031-0025
Mailing Address - Country:US
Mailing Address - Phone:502-222-7144
Mailing Address - Fax:502-222-6159
Practice Address - Street 1:501 PARKER PL UNIT 200
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:KY
Practice Address - Zip Code:40031-2229
Practice Address - Country:US
Practice Address - Phone:502-222-7144
Practice Address - Fax:502-222-6159
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY25818207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY50005421OtherPASSPORT
KY64258189Medicaid
KY000000346538OtherANTHEM BCBS
KY0936801Medicare ID - Type Unspecified
KYP00175643Medicare PIN
C76121Medicare UPIN