Provider Demographics
NPI:1861507667
Name:KIMBLE, CATHERINE R (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:R
Last Name:KIMBLE
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 1:9 MERIAM ST
Mailing Address - Street 2:SUITE 22
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-5300
Mailing Address - Country:US
Mailing Address - Phone:781-861-8206
Mailing Address - Fax:
Practice Address - Street 1:9 MERIAM ST
Practice Address - Street 2:SUITE #22
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-5300
Practice Address - Country:US
Practice Address - Phone:781-861-8206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA750902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry