Provider Demographics
NPI:1467403378
Name:JAMES, KIMBERLY L (MD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:L
Last Name:JAMES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 THOMPSON RD
Mailing Address - Street 2:
Mailing Address - City:COOS BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97420-2195
Mailing Address - Country:US
Mailing Address - Phone:541-269-0333
Mailing Address - Fax:541-269-7389
Practice Address - Street 1:1750 THOMPSON RD
Practice Address - Street 2:
Practice Address - City:COOS BAY
Practice Address - State:OR
Practice Address - Zip Code:97420-2195
Practice Address - Country:US
Practice Address - Phone:541-269-0333
Practice Address - Fax:541-269-7389
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0005186207V00000X
ORMD26438207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR243002Medicaid