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Individual

RANDALL MARK KIMBALL II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1 WEST AVE, SUITE 125, SARATOGA SPRINGS, NY 12866-6045
(518) 693-4418
(518) 693-4481
Mailing address
1 WEST AVE, SUITE 125, SARATOGA SPRINGS, NY 12866-6045
(518) 693-4418
(518) 693-4481

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
271859
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03649552
NY
Enumeration date
06/12/2008
Last updated
06/06/2014
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