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Individual

DR. DAVID LAWRENCE KIMBALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
725 JESSE JEWELL PKWY SE, GAINESVILLE, GA 30501-3834
(770) 539-9391
(770) 533-4701
Mailing address
PO BOX 658, GAINESVILLE, GA 30503-0658
(770) 533-6511
(770) 533-4786

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
047228
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00834281A
GA
01
300098921
RAILROAD MEDICARE
GA
01
581177261A
MEDICARE GRP PROV #
GA
Enumeration date
05/06/2006
Last updated
03/06/2019
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