Individual
RICHARD WILLIAM KIMMERLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5610 FORKWOOD DR NW, ACWORTH, GA 30101-8023
(770) 590-8915
(770) 218-0998
Mailing address
5610 FORKWOOD DR NW, ACWORTH, GA 30101-8023
(770) 590-8915
(770) 218-0998
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
11710
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00068054A
—
GA
01
—
10047230
AMERIGREEN
—
Enumeration date
09/07/2006
Last updated
07/08/2007
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