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1265134498
SAMUEL KIMBROUGH
EDMOND, OK
NPI
1265134498
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Additional Taxonomies
363AM0700X Physician Assistant, Medical
Enumeration Date
2023-03-21
Last Update Date
2023-03-23
Business Address
SAMUEL KIMBROUGH PA-C
1701 RENAISSANCE BLVD STE 110
EDMOND, OK 73013-3084
Phone number: 405-844-4978
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Mailing Address
SAMUEL KIMBROUGH PA-C
301 N WALKER AVE APT 8101
OKLAHOMA CITY, OK 73102-1871
Phone number: 580-721-0409
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