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RANDAL S. KIMBROUGH NPI 1174879894


NPI Information

NPI: 1174879894
Provider Name: RANDAL S. KIMBROUGH
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
2702 AMERICAN ST
SPRINGDALE, AR
ZIP 72764
Phone: (479) 751-9899
Get Directions

RANDAL S. KIMBROUGH is a general practice dentist in Springdale, AR. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. RANDAL S. KIMBROUGH NPI is 1174879894. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2702 AMERICAN ST
SPRINGDALE, AR
ZIP 72764-937
Phone: (479) 751-9899

The provider's authorized official is Marsha Kimbrough .
The authorized official title is Office Manager and has the following contact phone number (479) 751-9899.

The enumeration date for this NPI number is 7/31/2012 and was last updated on 7/31/2012.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral PracticeYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1177728608MEDICAIDARKANSAS

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: 4/28/2024

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