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General NPI Number Information
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NPI Number | 1295706612
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Entity Type | Individual
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Provider Name | PAMELA LYNN KIMBROUGH MD
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Gender | Female
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 08/04/2008
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Provider Practice Location Address
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Address Line | 970 NORTHWEST BLVD
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City | ARDMORE
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State | OK
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Zip | 73401
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Country | US
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Telephone | 580-221-7500
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Fax | 580-490-9841
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Provider Business Mailing Address
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Address Line | PO BOX 216
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City | ARDMORE
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State | OK
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Zip | 73402-0216
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Country | US
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Telephone | 580-221-7500
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Fax | 580-490-9841
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 16248
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License Number State | OK
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