Kimbrell, Blake Steven

Kimbrell, Blake Steven is an individual health care provider with primary practice located at 150 Nacoochee Ave , Athens GA 30601-1823. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Kimbrell, Blake Steven can be contacted via phone (706) 546-7908.

Contact Information

Primary practice address
150 Nacoochee Ave Athens GA 30601-1823
Phone: (706) 546-7908
Fax: (706) 546-1944
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 262561 Massachusetts
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 0101258556 Virginia
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 75683 Georgia

Profile Details

NPI number 1144545096
LBN Legal business name Kimbrell, Blake Steven
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2010
Last updated Jun 7th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144545096 NPPES
Georgia MEDICAID 003176590A

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