Individual
DR. BAYLEN GREGORY KIMBALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2900 MOSS ST STE F, LAFAYETTE, LA 70501-1268
(337) 232-1103
(337) 232-5384
Mailing address
312 SAWGRASS LN, BROUSSARD, LA 70518-6149
(337) 856-4653
(337) 232-5384
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01540
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1338044
—
LA
Enumeration date
04/13/2007
Last updated
07/08/2007
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