Provider Demographics
NPI:1104088384
Name:KEMPKEN, THOMAS GEORGE (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:GEORGE
Last Name:KEMPKEN
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 1:5991 N GOLDEN EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-0818
Mailing Address - Country:US
Mailing Address - Phone:520-529-2208
Mailing Address - Fax:520-529-2209
Practice Address - Street 1:5991 N GOLDEN EAGLE DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85750-0818
Practice Address - Country:US
Practice Address - Phone:520-529-2208
Practice Address - Fax:520-529-2208
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15871-020172V00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No172V00000XOther Service ProvidersCommunity Health Worker