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Individual
KIMBERLY MIDDLETON
Active
Individual
KIMBERLY MIDDLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
S4192
TX
207QA0505X
Adult Medicine Physician
036103921
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080H262390
BLUE CROSS-BLUE CROSS
—
05
—
484049210
—
MI
01
—
KM086980
CHAMPUS-CHAMPUS
—
Enumeration date
03/07/2006
Last updated
07/15/2021
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