Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 2006018907 | MO |
NPI | 1194876805 |
---|---|
Provider Name | Dr. Edgar N Kemp III |
First Address | Kirksville, MO 63501 |
Second Address | Kirksville, MO 63501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 23/09/2021 |