Provider Demographics
NPI:1447463203
Name:KEMP COREIL MD APMC
Entity type:Organization
Organization Name:KEMP COREIL MD APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KEMP
Authorized Official - Middle Name:
Authorized Official - Last Name:COREIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-504-3335
Mailing Address - Street 1:105 PATRIOT ST STE 202
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6831
Mailing Address - Country:US
Mailing Address - Phone:337-504-7979
Mailing Address - Fax:337-534-0252
Practice Address - Street 1:105 PATRIOT ST STE 202
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6831
Practice Address - Country:US
Practice Address - Phone:337-504-7979
Practice Address - Fax:337-534-0252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12561R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1541494Medicaid
LAG70296Medicare UPIN
LA1541494Medicaid