Provider Demographics
NPI:1124205133
Name:THOMAS M IRWIN JR MD JOHN G KIMBLE MD APMC
Entity Type:Organization
Organization Name:THOMAS M IRWIN JR MD JOHN G KIMBLE MD APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:IRWIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:504-349-6400
Mailing Address - Street 1:1151 BARATARIA BLVD STE 3100
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-3083
Mailing Address - Country:US
Mailing Address - Phone:504-934-8461
Mailing Address - Fax:
Practice Address - Street 1:1151 BARATARIA BLVD STE 3100
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-3083
Practice Address - Country:US
Practice Address - Phone:504-934-8461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty