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General NPI Number Information
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NPI Number | 1467627711
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Entity Type | Organization
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Legal Business Name | RONALD W KIMBALL M D P C
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 10/27/2010
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Provider Practice Location Address
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Address Line | 7701 LINDBERGH BLVD SUITE 713
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City | PHILADELPHIA
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State | PA
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Zip | 19153-2132
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Country | US
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Telephone | 215-365-1113
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Fax | 215-365-1114
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Provider Business Mailing Address
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Address Line | 1 WINGATE CT
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City | FLOURTOWN
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State | PA
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Zip | 19031-1117
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Country | US
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Telephone | 215-365-1113
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Fax | 215-365-1114
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Authorized Official
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Title or Position | PRESIDENT
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Name | RONALD W KIMBALL
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Credential | M.D.
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Telephone | 215-365-1113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD015251E
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License Number State | PA
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