Individual
DR. KIMBERLY ROSE AZELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4410 HOLT RD, HOLT, MI 48842-1673
(574) 647-7477
(574) 647-3655
Mailing address
4410 HOLT RD, HOLT, MI 48842-1673
(517) 258-0855
(517) 210-2202
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01084056A
IN
207Q00000X
Family Medicine Physician
Primary
4301504512
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300005661
—
IN
Enumeration date
04/21/2017
Last updated
03/23/2026
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