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General NPI Number Information
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NPI Number | 1568585776
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Entity Type | Individual
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Provider Name | JAMES FITZHUGH KIMBROUGH MD
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Gender | Male
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 07/29/2009
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Provider Practice Location Address
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Address Line | 340 NORTH BELAIR ROAD
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City | EVANS
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State | GA
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Zip | 30809-3000
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Country | US
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Telephone | 706-868-5676
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Fax | 706-722-2824
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Provider Business Mailing Address
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Address Line | 340 NORTH BELAIR ROAD
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City | EVANS
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State | GA
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Zip | 30809-3000
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Country | US
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Telephone | 706-868-5676
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Fax | 706-722-2824
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 01061318A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 062714
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License Number State | GA
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