Individual
MR. THOMAS J KIMBLE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2435 FOREST DR, COLUMBIA, SC 29204-2026
(803) 256-5300
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
367500000X
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
89892
NBCRNA
SC
05
—
AN2238
—
SC
Enumeration date
01/03/2012
Last updated
02/08/2022
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