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General NPI Number Information
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NPI Number | 1710197744
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Entity Type | Individual
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Provider Name | KIMBERLY L MATCHETT M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 06/03/2013
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Provider Practice Location Address
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Address Line | 315 HOSPITAL DR SUTIE 105
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City | MARTINSVILLE
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State | VA
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Zip | 24112-1945
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Country | US
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Telephone | 276-634-0050
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Fax | 276-634-0040
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Provider Business Mailing Address
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Address Line | 315 HOSPITAL DR SUITE 105
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City | MARTINSVILLE
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State | VA
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Zip | 24112-1945
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Country | US
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Telephone | 276-634-0050
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Fax | 276-634-0040
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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 | 0101241213
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License Number State | VA
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