MEDICARE: KRISTOPHER J. KIMBALL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VX0201X	Gynecologic Oncology Physician	45968	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073721635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTOPHER J. KIMBALL MD

Provider Business Mailing Address
First Line	:	PO BOX 440459
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37244-0459
Country	:	US
Telephone Number	:	865-670-6199
Fax Number	:	865-670-6188

Provider Business Practice Location Address
First Line	:	1934 ALCOA HWY
Second Line	:	STE 478
City	:	KNOXVILLE
State	:	TN
Zip	:	37920-1524
Country	:	US
Telephone Number	:	865-305-5622
Fax Number	:	865-305-4580

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	01/11/2011

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