Individual
KIMBERLY L BALASKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
49494 HIGHWAY 17, SULLIGENT, AL 35586-4454
(205) 698-7111
(205) 698-0516
Mailing address
49494 HIGHWAY 17, SULLIGENT, AL 35586-4454
(205) 698-7111
(256) 698-0516
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D.O.859
AL
207Q00000X
Family Medicine Physician
DO859
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063481489
—
AL
05
—
114077
—
AL
01
—
E869
MDCR GROUP
—
Enumeration date
03/16/2006
Last updated
11/18/2009
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