Provider Demographics
NPI:1932170602
Name:KEMPER, EDDIE P (MD)
Entity Type:Individual
Prefix:
First Name:EDDIE
Middle Name:P
Last Name:KEMPER
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 1:8885 STATE ROAD 237
Mailing Address - Street 2:
Mailing Address - City:TELL CITY
Mailing Address - State:IN
Mailing Address - Zip Code:47586-8567
Mailing Address - Country:US
Mailing Address - Phone:812-547-7011
Mailing Address - Fax:
Practice Address - Street 1:109 US HIGHWAY 66 E
Practice Address - Street 2:
Practice Address - City:TELL CITY
Practice Address - State:IN
Practice Address - Zip Code:47586-2799
Practice Address - Country:US
Practice Address - Phone:812-547-3447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53369207V00000X
WAMD60632888207V00000X
TXK4100207V00000X
IN01074786A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0046CFOtherBC/BS
TXP00075809OtherMCR/RR
TX030589801OtherSUPERIOR HEALTH CHIP
TX8GJ911OtherBCBSTX
TX030589801Medicaid
TX742857480OtherTRICARE
TXP00075809OtherMCR/RR
TX0054CDMedicare PIN