Provider Demographics
NPI:1215967393
Name:KEMPF, THOMAS W (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:W
Last Name:KEMPF
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 6001
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58108-6001
Mailing Address - Country:US
Mailing Address - Phone:701-364-3300
Mailing Address - Fax:701-364-8906
Practice Address - Street 1:1702 UNIVERSITY DR S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-4940
Practice Address - Country:US
Practice Address - Phone:701-364-3300
Practice Address - Fax:701-364-8906
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ND4271207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND0402521OtherFGO MEDICA #
ND0404039OtherINN MEDICA #
ND1040OtherNDBS #
ND142022OtherUCARE #
MN4994IKEOtherMOORHEAD MNBS #
NDDA9011015548OtherPREF 1 #
ND676607OtherARAZ #
ND14184Medicaid
ND3417OtherSIOUX VALLEY #
ND410763200Medicaid
ND91484KEOtherFARGO MNBS #
NDHP19550OtherHEALTHPARTNERS #
ND119000739OtherMNMD FGO OUTREACH #
MN4994IKEOtherMOORHEAD MNBS #
ND110050439Medicare ID - Type UnspecifiedRAILROAD MEDICARE
ND1040Medicare ID - Type UnspecifiedNDMD #