Individual
MICHAEL K KIMBRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1901 S SHADY ST, MOUNTAIN CITY, TN 37683-2021
(423) 727-1100
(423) 727-1105
Mailing address
1901 S SHADY ST, MOUNTAIN CITY, TN 37683-2021
(423) 727-1100
(423) 727-1105
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD24044
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3859222
—
TN
01
—
4062631
BCBS
TN
01
—
TN01661
JOHN DEERE
TN
Enumeration date
04/26/2006
Last updated
12/18/2009
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