Provider Demographics
NPI:1285663732
Name:KIMBLE, JAMES ALLEN (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ALLEN
Last Name:KIMBLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 11TH AVE S
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-3423
Mailing Address - Country:US
Mailing Address - Phone:205-933-2625
Mailing Address - Fax:205-558-2553
Practice Address - Street 1:1201 11TH AVE S
Practice Address - Street 2:SUITE 300
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-3423
Practice Address - Country:US
Practice Address - Phone:205-933-2625
Practice Address - Fax:205-558-2553
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12048207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051550342Medicaid
ALC75199Medicare UPIN
AL051550342Medicare ID - Type Unspecified