Individual
JIMMY CLARKE KIMBALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4600 ASHEVILLE HWY, KNOXVILLE, TN 37914-3665
(865) 522-8114
(866) 550-6541
Mailing address
PO BOX 15004, KNOXVILLE, TN 37901-5004
(865) 541-8895
(865) 633-4808
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
13576
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6165200
BLUE CROSS BLUE SHIELD PROVIDER ID
TN
05
—
Q007841
—
TN
Enumeration date
09/07/2006
Last updated
10/13/2020
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