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Individual

KOBY KIMBALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
619 E MASON ST, SPRINGFIELD, IL 62701-1034
(217) 788-0706
(217) 525-2535
Mailing address
619 E MASON ST, SPRINGFIELD, IL 62701-1034
(217) 788-0706
(217) 525-2535

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
01/10/2023
Last updated
09/16/2025
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