Provider Demographics
NPI:1174107460
Name:KEMP, PETER KARL (DPM)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:KARL
Last Name:KEMP
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:30 S KYRENE RD STE 3
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-4722
Mailing Address - Country:US
Mailing Address - Phone:480-561-3734
Mailing Address - Fax:480-497-3947
Practice Address - Street 1:30 S KYRENE RD STE 3
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-4722
Practice Address - Country:US
Practice Address - Phone:480-561-3734
Practice Address - Fax:480-497-3947
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-12
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AZPOD-001109213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program