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MR. STEPHEN MICHAEL KIMBROUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1321 SUNSET DRIVE, SUITE 11, JOHNSON CITY, TN 37604-7902
(423) 928-6174
(423) 926-2258
Mailing address
1321 SUNSET DRIVE, SUITE 11, JOHNSON CITY, TN 37604-7902
(423) 928-6174
(423) 926-2258

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD012583
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0014824
BCBS
TN
05
006190821
VA
01
0140000838
CIGNA
01
026086900
BLACK LUNG COAL MINERS
01
027897
GM RETIREES
01
05920
NC STATE
NC
01
100027216
PHP CARITEN TENNCARE
01
1292658
UMWA
01
130014283
UNITED HEALTHCARE
01
164888600
OWCP DEPT OF LABOR
05
3180257
TN
01
602003807
PHP CARITEN
05
64796949
KY
05
7905920
NC
01
A55605
JOHN DEERE
Enumeration date
05/20/2006
Last updated
03/08/2016
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