Basic Information
| Provider Information | |||||||||
| NPI: | 1780676809 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALUMBAUGH | ||||||||
| FirstName: | KIMBERLY | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6801 DIXIE HWY | ||||||||
| Address2: | STE 130 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402583913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5028949494 | ||||||||
| FaxNumber: | 5028949404 | ||||||||
| Practice Location | |||||||||
| Address1: | 4121 DUTCHMANS LANE | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402074730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5028949494 | ||||||||
| FaxNumber: | 5028949404 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2005 | ||||||||
| LastUpdateDate: | 06/04/2012 | ||||||||
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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 | 207V00000X | 25211 | KY | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207VX0000X | 25211 | KY | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics |
ID Information
| ID | Type | State | Issuer | Description | 64252117 | 05 | KY | MEDICAID | P01026545 | 01 | KY | MEDICARE RAILROAD | OTHER |