| Derrick E Kimble Inc | |
|
2903 Galahad Way Augusta GA 30909-9147 | |
| (706) 495-2351 | |
| Not Available |
| Full Name | Derrick E Kimble Inc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2903 Galahad Way, Augusta, Georgia |
| Authorized Official Name and Position | Derrick E Kimble (CEO) |
| Authorized Official Contact | 7064952351 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Derrick E Kimble Inc 2903 Galahad Way Augusta GA 30909-9147 Ph: (706) 495-2351 | Derrick E Kimble Inc 2903 Galahad Way Augusta GA 30909-9147 Ph: (706) 495-2351 |
| NPI Number | 1902174345 |
|---|---|
| Provider Enumeration Date | 12/13/2011 |
| Last Update Date | 12/13/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902174345 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC005188 (Georgia) | Primary |
| 251J00000X | Nursing Care | RN107823 (Georgia) | Secondary |
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