Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0001X | Dental Public Health | 28757 | TX |
N | 1223G0001X | General Practice | 28757 | TX |
N | 213EG0000X | General Practice | 28757 | TX |
Y | 1223G0001X | General Practice | 6413 | LA |
Y | 213EG0000X | General Practice | 6413 | LA |
N | 1223G0001X | General Practice | 9458 | TN |
N | 213EG0000X | General Practice | 9458 | TN |
NPI | 1245526870 |
---|---|
Provider Name | Dr. Kimberly Smith Bibbins |
First Address | Franklin, LA 70538-4124 |
Second Address | Franklin, LA 70538-4124 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2011 |
Last Update Date | 22/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00HE78 | MEDICARE PART B - GROUP (01) | TX |
126826002 | (05) | TX |
2890573 | (05) | LA |
451821 | MEDICARE PART A - GROUP (01) | TX |
5B803 | MEDICARE PART B - GROUP (01) | LA |