Individual
KIMBRELL L COLBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
805 SAINT VINCENTS DR, SUITE 100, BIRMINGHAM, AL 35205-1636
(205) 939-3699
(205) 939-0989
Mailing address
805 SAINT VINCENTS DR, SUITE 100, BIRMINGHAM, AL 35205-1636
(205) 939-3000
(205) 930-0008
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA7
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42595
—
AL
01
—
51527784
BCBS
AL
Enumeration date
03/01/2006
Last updated
09/25/2012
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