MEDICARE: DR. BART WADE KIMBRELL 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	2085R0202X	Diagnostic Radiology Physician	66961	GA
2	2085R0202X	Diagnostic Radiology Physician	0101288054	VA

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	:	1922319599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BART WADE KIMBRELL M.D.

Provider Business Mailing Address
First Line	:	700 WILMINGTON ISLAND RD APT 503
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31410-4532
Country	:	US
Telephone Number	:	770-540-5497
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 W ACADEMY STREET
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30501
Country	:	US
Telephone Number	:	770-282-8820
Fax Number	:

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

Provider Enumeration Date	:	06/28/2010
Last Update Date	:	12/10/2025

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