MEDICARE: JILL SINIARD KIMBROUGH 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	2084P0800X	Psychiatry Physician	16002	AL

General Provider Information

NPI Number	:	1932393410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL SINIARD KIMBROUGH M.D.

Provider Business Mailing Address
First Line	:	3516 COUNTRYWOOD LN
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35243-2419
Country	:	US
Telephone Number	:	205-969-1680
Fax Number	:

Provider Business Practice Location Address
First Line	:	3104 BLUE LAKE DR
Second Line	:	SUITE 100
City	:	BIRMINGHAM
State	:	AL
Zip	:	35243-2306
Country	:	US
Telephone Number	:	205-977-3003
Fax Number	:

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

Provider Enumeration Date	:	08/28/2007
Last Update Date	:	08/28/2007

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