Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 57000-20 | WI |
NPI | 1083930622 |
---|---|
Provider Name | Steven J Kempton |
First Address | Madison, WI 53717-2236 |
Second Address | Madison, WI 53717 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2010 |
Last Update Date | 25/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1083930622 | (05) | WI |