Basic Information
| Provider Information | |||||||||
| NPI: | 1184915241 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KEMPE | ||||||||
| FirstName: | MEGAN | ||||||||
| MiddleName: | HICKS | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 736387 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753736387 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8884905457 | ||||||||
| FaxNumber: | 8434105519 | ||||||||
| Practice Location | |||||||||
| Address1: | 4250 BETHEL RD DEPT OF | ||||||||
| Address2: | |||||||||
| City: | OLIVE BRANCH | ||||||||
| State: | MS | ||||||||
| PostalCode: | 386548737 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9015167182 | ||||||||
| FaxNumber: | 9012765474 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2011 | ||||||||
| LastUpdateDate: | 10/12/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207ZC0500X | 24417 | MS | Y | Allopathic & Osteopathic Physicians | Pathology | Cytopathology |
No ID Information.