Organization
TRAVIS JAY KEMP MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRAVIS JAY KEMP MD (CEO/OWNER)
(208) 473-0333
Entity
Organization
Contact information
Practice address
7979 W RIFLEMAN ST, BOISE, ID 83704-9066
(208) 855-2410
(208) 855-0157
Mailing address
7979 W RIFLEMAN ST, BOISE, ID 83704-9066
(208) 855-2410
(208) 855-0157
Taxonomy
Speciality
Code
Description
License number
State
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
M-10673
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
808378000
—
ID
Enumeration date
07/28/2013
Last updated
07/28/2013
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