Individual
JACKSON ELLIS KIMBROUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
619 19TH ST S, BIRMINGHAM, AL 35233-1900
(205) 934-4011
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.2760
AL
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/09/2025
Last updated
04/17/2026
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