Individual
ERIC RYAN KIMMEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11104 PARKVIEW CIRCLE DR STE 110, FORT WAYNE, IN 46845-1673
(260) 425-6780
(260) 425-6789
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
01083724A
IN
2084N0400X
Neurology Physician
LL84349
SC
2084N0400X
Neurology Physician
R-10600
IA
Other
Enumeration date
05/27/2016
Last updated
10/17/2022
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