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1740419688
KIMBERLY TERESA FOUNTAIN
AUGUSTA, GA
NPI
1740419688
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: TN 207R0000X)
Enumeration Date
2009-07-14
Last Update Date
2015-07-07
Business Address
-- KIMBERLY TERESA FOUNTAIN MD,MS
GRU 1120 15TH STREET
AUGUSTA, GA 30912-0001
Phone number: 706-834-0190
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Mailing Address
-- KIMBERLY TERESA FOUNTAIN MD,MS
450 RAILROAD AVE STE 1-D
NORTH AUGUSTA, SC 29841-3782
Phone number: 801-671-0933
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