Individual
DOUGLAS J KIMMEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
305 S STATE ST, ABERDEEN, SD 57401-4527
(605) 622-5000
Mailing address
24 2ND AVE SW, ABERDEEN, SD 57401-4115
(605) 725-2560
(605) 725-8782
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
3940
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008378
BCBS
SD
05
—
099816800
—
MN
05
—
18453
—
ND
01
—
21258
BCBS
ND
05
—
7201012
—
SD
Enumeration date
06/22/2006
Last updated
11/16/2011
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