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Individual

DR. RONALD WAYNE KIMBALL

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7701 LINDBERGH BLVD, STE 713, PHILADELPHIA, PA 19153
(215) 365-1113
(215) 365-1114
Mailing address
1 WINGATE COURT, FLOURTOWN, PA 19031
(215) 233-4639

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
MA33892
NJ
207W00000X
Ophthalmology Physician
Primary
MD015251E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0006528790001
PA
Enumeration date
03/14/2006
Last updated
07/08/2007
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