Basic Information
| Provider Information | |||||||||
| NPI: | 1093742546 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KIMBERLIN | ||||||||
| FirstName: | DEBORA | ||||||||
| MiddleName: | F | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 55310 | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352555310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2057319701 | ||||||||
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| Practice Location | |||||||||
| Address1: | 619 19TH STREET SOUTH | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059344011 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2006 | ||||||||
| LastUpdateDate: | 08/31/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VM0101X | 18061 | AL | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Maternal & Fetal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 009948085 | 05 | AL | MEDICAID | 009949745 | 05 | AL | MEDICAID | 009949755 | 05 | AL | MEDICAID | 009970515 | 05 | AL | MEDICAID | 051521080 | 01 | AL | BLUE CROSS | OTHER | 051521082 | 01 | AL | BLUE CROSS | OTHER | 009948095 | 05 | AL | MEDICAID | 051554450 | 05 | AL | MEDICAID | 009949765 | 05 | AL | MEDICAID | 009961375 | 05 | AL | MEDICAID | 009970505 | 05 | AL | MEDICAID | 009982435 | 05 | AL | MEDICAID | 051093927 | 01 | AL | BLUE CROSS | OTHER | 051521079 | 01 | AL | BLUE CROSS | OTHER | 009944425 | 05 | AL | MEDICAID | 051521078 | 01 | AL | BLUE CROSS | OTHER | 009971445 | 05 | AL | MEDICAID | 051521081 | 01 | AL | BLUE CROSS | OTHER | 009949725 | 05 | AL | MEDICAID | 009949735 | 05 | AL | MEDICAID |