Healthcare Provider Details

I. General information

NPI: 1144223801
Provider Name (Legal Business Name): KIMBERLY A KOLAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIMBERLY A KOLAR M.D.

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 05/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 W MOANA LN STE 2
RENO NV
89509-4857
US

IV. Provider business mailing address

3950 G.S. RICHARDS BLVD.
CARSON CITY NV
89703-8457
US

V. Phone/Fax

Practice location:
  • Phone: 775-324-0699
  • Fax: 775-888-8067
Mailing address:
  • Phone: 775-324-0699
  • Fax: 775-888-8067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number8012
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: