Organization
NEOSOM CLINICS DBA ENT & SLEEP MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY PAUL KIMBERLEY M.D. (PRESIDENT)
(612) 465-0123
Entity
Organization
Contact information
Practice address
7261 OHMS LN, EDINA, MN 55439-2148
(612) 465-0123
(952) 843-4301
Mailing address
700 MEDICAL CENTER DR, SUITE 101, NEWTON, KS 67114-9013
(316) 283-2828
(316) 283-2830
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
04-32263
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200577150A
—
KS
Enumeration date
07/15/2010
Last updated
07/15/2010
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