Individual
RENEE D. KIMBALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4754 MARTIN RD, FLOWERY BRANCH, GA 30542-3507
(770) 965-0847
(770) 965-0974
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
(770) 219-8440
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
048253
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00860296B
—
GA
Enumeration date
08/22/2005
Last updated
12/18/2015
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