Provider Demographics
NPI:1386696599
Name:KEMERER, JOHN JOSEPH (DO)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JOSEPH
Last Name:KEMERER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 HEALTH CENTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701
Mailing Address - Country:US
Mailing Address - Phone:740-593-1660
Mailing Address - Fax:740-593-0179
Practice Address - Street 1:2 HEALTH CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701
Practice Address - Country:US
Practice Address - Phone:740-593-1660
Practice Address - Fax:740-593-0179
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34010538207Q00000X
MI5101010925207Q00000X
FLOS14998207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0065404Medicaid
MI3040574Medicaid
MI3040574Medicaid
OH0065404Medicaid