MEDICARE: DR. KIMBERLY ROSSER CARR D.M.D.

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	1223P0221X	Pediatric Dentistry	4666	AL

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	:	1730297276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY ROSSER CARR D.M.D.

Provider Business Mailing Address
First Line	:	PO BOX 59202
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35259-9202
Country	:	US
Telephone Number	:	205-939-4912
Fax Number	:	205-939-4915

Provider Business Practice Location Address
First Line	:	1801 14TH AVE S
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35205-4931
Country	:	US
Telephone Number	:	205-939-4912
Fax Number	:	205-939-4915

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

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	09/28/2011

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Directions to “ DR. KIMBERLY ROSSER CARR D.M.D.” Practice Location

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