Prentiss, Kimball A
Prentiss, Kimball A is an individual health care provider with primary practice located at 759 Chestnut St , Springfield MA 01199-1619. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is her primary health care specialty. Prentiss, Kimball A can be contacted via phone (413) 794-3233.Contact Information
Primary practice address
759 Chestnut St
Springfield MA 01199-1619
Phone: (413) 794-3233
Fax: (413) 794-9060
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 224057 | Massachusetts |
| Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 2080P0204X | 224057 | Massachusetts |
Profile Details
| NPI number | 1972555670 |
|---|---|
| LBN Legal business name | Prentiss, Kimball A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 17th, 2006 |
| Last updated | Mar 21st, 2015 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972555670 | NPPES |
| Massachusetts | MEDICAID | 110041041A |
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