Individual
THOMAS DUDLEY KIMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
825 FAIRFAX AVE, NORFOLK, VA 23507-1914
(757) 625-0557
(757) 625-1361
Mailing address
PO BOX 936, NORFOLK, VA 23501-0936
(757) 625-0557
(757) 625-1361
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0101240761
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-010
TRICARE/CHAMPUS
VA
01
—
06151
BC/BS
NC
01
—
10015910
SENTARA
VA
05
—
1649359993
—
VA
01
—
2165745
UHC/MAMSI (OB/GYN)
VA
01
—
293664
ANTHEM
VA
01
—
3166745
UHC/MAMSI (GYN)
VA
05
—
5906151
—
NC
01
—
PAR
USA MANAGED CARE
VA
Enumeration date
11/06/2006
Last updated
01/26/2009
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