Provider Demographics
NPI:1780991133
Name:ALUMBAUGH, KIMBERLY DAWN (OD)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:DAWN
Last Name:ALUMBAUGH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MS
Other - First Name:KIMBERLY
Other - Middle Name:DAWN
Other - Last Name:KNOBLETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:905 W MEFFORD ST
Mailing Address - Street 2:
Mailing Address - City:ROBINSON
Mailing Address - State:IL
Mailing Address - Zip Code:62454-1065
Mailing Address - Country:US
Mailing Address - Phone:618-544-3525
Mailing Address - Fax:618-544-3261
Practice Address - Street 1:905 W MEFFORD ST
Practice Address - Street 2:
Practice Address - City:ROBINSON
Practice Address - State:IL
Practice Address - Zip Code:62454-1065
Practice Address - Country:US
Practice Address - Phone:618-544-3525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-07
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL346.003630152W00000X
IN18003662A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist