Individual
KIMBERLY CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
809 CLEVELAND AVE SW, ATLANTA, GA 30315-7108
(404) 767-2536
(404) 767-2779
Mailing address
809 CLEVELAND AVE SW, ATLANTA, GA 30315-7108
(404) 767-2536
(404) 767-2779
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
033047
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202I167828
MEDICARE NUMBER
GA
Enumeration date
07/29/2005
Last updated
04/11/2022
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