Provider Demographics
NPI:1528240199
Name:KIMBERLY, JAMES R JR (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:KIMBERLY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4800 BELFORT RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6004
Mailing Address - Country:US
Mailing Address - Phone:904-398-3262
Mailing Address - Fax:904-265-4807
Practice Address - Street 1:1883 KINGSLEY AVE
Practice Address - Street 2:STE 1100
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4479
Practice Address - Country:US
Practice Address - Phone:904-264-9797
Practice Address - Fax:904-264-4644
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2011-05-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME 101619207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000166400Medicaid
FL000166400Medicaid