Provider Demographics
NPI:1255477634
Name:KIMBERLING, C F JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:C
Middle Name:F
Last Name:KIMBERLING
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19635
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73144-0635
Mailing Address - Country:US
Mailing Address - Phone:405-692-2118
Mailing Address - Fax:405-605-5816
Practice Address - Street 1:3035 NW 63RD ST
Practice Address - Street 2:STE 1010684
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-3632
Practice Address - Country:US
Practice Address - Phone:405-842-0684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor