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General NPI Number Information
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NPI Number | 1922319599
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Entity Type | Individual
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Provider Name | BART WADE KIMBRELL M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/28/2010
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 200 W ACADEMY STREET
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City | GAINESVILLE
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State | GA
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Zip | 30501
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Country | US
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Telephone | 770-282-8820
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Fax |
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Provider Business Mailing Address
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Address Line | 700 WILMINGTON ISLAND RD APT 503
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City | SAVANNAH
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State | GA
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Zip | 31410-4532
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Country | US
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Telephone | 770-540-5497
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 66961
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 0101288054
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License Number State | VA
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