Individual
DR. KIMBERLY EDGMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2820 N KELLY AVE, SUITE 200, EDMOND, OK 73003-3007
(405) 726-8000
(405) 726-8101
Mailing address
2820 N KELLY AVE, SUITE 200, EDMOND, OK 73003-3007
(405) 726-8000
(405) 726-8101
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
24371
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200057440A
—
OK
01
—
24371
LICENSE
OK
01
—
33536
OBNDD
OK
Enumeration date
03/27/2006
Last updated
05/27/2016
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