Individual
DR. BRIAN B KIMMEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4517 E THOMPSON ST, PHILADELPHIA, PA 19137-2003
(215) 535-1275
(215) 535-8690
Mailing address
4517 E THOMPSON ST, PHILADELPHIA, PA 19137-2003
(215) 535-1275
(215) 535-8690
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS005625L
PA
311Z00000X
Custodial Care Facility
OS-005625L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011449090003
—
PA
Enumeration date
06/06/2006
Last updated
09/23/2013
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