RICHARD WILLIAM KIMMERLING MD NPI 1174626543

NPI Information

NPI: 1174626543
Provider Name: RICHARD WILLIAM KIMMERLING, MD
Classification: General Practice - 208D00000X
Entity Type: Individual
Address:
5610 FORKWOOD DR NW
ACWORTH, GA
ZIP 30101
Phone: (770) 590-8915
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Richard William Kimmerling, MD is a general practice in Acworth, GA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee Richard William Kimmerling, MD NPI is 1174626543. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5610 FORKWOOD DR NW
ACWORTH, GA
ZIP 30101-023
Phone: (770) 590-8915
Fax: (770) 218-0998

The enumeration date for this NPI number is 9/7/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice		11710	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	D70510	MEDICARE UPIN
2	00068054A	MEDICAID	GEORGIA
3	10047230	OTHER		AMERIGREEN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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