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NPI Code Detail

MEDICARE: MARK TROY KIMPTON MD

MEDICARE: MARK TROY KIMPTON 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
1207Q00000XFamily Medicine Physician35072211OH
2207Q00000XFamily Medicine Physician2018-01739NC

Other Identifiers

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

General Provider Information

NPI Number : 1124094669
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK TROY KIMPTON MD
Provider Business Mailing Address
First Line : 804 ENGLISH RD STE 100
Second Line :
City : ROCKY MOUNT
State : NC
Zip : 27804-6027
Country : US
Telephone Number : 252-443-3133
Fax Number : 252-443-0847
Provider Business Practice Location Address
First Line : 804 ENGLISH RD STE 100
Second Line :
City : ROCKY MOUNT
State : NC
Zip : 27804-6027
Country : US
Telephone Number : 252-443-3133
Fax Number : 252-443-0847
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2006
Last Update Date : 11/22/2021

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