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Individual

SAMYUKTHA VANI KEMPARAJURS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
501 PARKER PL UNIT 200, LA GRANGE, KY 40031-2229
(502) 222-7144
Mailing address
501 PARKER PL UNIT 200, LA GRANGE, KY 40031-2229
(502) 222-7144

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
53626
KY
207Q00000X
Family Medicine Physician
92110
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100569380
KY
01
K255240
MEDICARE
KY
Enumeration date
03/17/2017
Last updated
12/26/2024
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