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NPI Code Detail

MEDICARE: DR. KIMBERLY TYXINE THURMOND DPM

MEDICARE: DR. KIMBERLY TYXINE THURMOND DPM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213E00000XPodiatrist2180MA
2213ES0131XFoot Surgery Podiatrist2180MA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3480033626OTHERMAMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Y71094OTHERMABLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376557942
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KIMBERLY TYXINE THURMOND DPM
Provider Business Mailing Address
First Line : 84 ELMER RD
Second Line :
City : WEYMOUTH
State : MA
Zip : 02190-1202
Country : US
Telephone Number : 781-335-0433
Fax Number :
Provider Business Practice Location Address
First Line : 45 DIMOCK ST
Second Line :
City : ROXBURY
State : MA
Zip : 02119-1208
Country : US
Telephone Number : 617-442-8800
Fax Number : 617-442-4088
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2006
Last Update Date : 04/13/2020

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Directions to “ DR. KIMBERLY TYXINE THURMOND DPM” Practice Location

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