Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | 35.080912 | OH |
NPI | 1316021363 |
---|---|
Provider Name | David R. Kimberly |
First Address | Akron, OH 44320 |
Second Address | Akron, OH 44320 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 22/10/2020 |