Basic Information
| Provider Information | |||||||||
| NPI: | 1386696599 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KEMERER | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 2 HEALTH CENTER DRIVE | ||||||||
| Address2: | |||||||||
| City: | ATHENS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7405931660 | ||||||||
| FaxNumber: | 7405930179 | ||||||||
| Practice Location | |||||||||
| Address1: | 2 HEALTH CENTER DRIVE | ||||||||
| Address2: | |||||||||
| City: | ATHENS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7405931660 | ||||||||
| FaxNumber: | 7405930179 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2006 | ||||||||
| LastUpdateDate: | 03/17/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 03/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 34010538 | OH | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 5101010925 | MI | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | OS14998 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0065404 | 05 | OH | MEDICAID | 3040574 | 05 | MI | MEDICAID |