Individual
JAMES KIMBALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
791 JONESTOWN RD, WINSTON SALEM, NC 27103-1252
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
901426
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13330
BCBS
NC
05
—
2004925000
—
WV
05
—
7119585
—
VA
01
—
7688778
AETNA
—
01
—
802688
PARTNERS
NC
05
—
8913330
—
NC
01
—
C5487
MEDCOST
NC
05
—
Q0142F
—
SC
Enumeration date
12/02/2005
Last updated
11/01/2012
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