Provider Demographics
NPI:1699349894
Name:KIMBERLY G KINARD LLC
Entity type:Organization
Organization Name:KIMBERLY G KINARD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:GALE
Authorized Official - Last Name:KINARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-238-9201
Mailing Address - Street 1:4711 FOREST DR STE 3
Mailing Address - Street 2:#251
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29206-3125
Mailing Address - Country:US
Mailing Address - Phone:803-818-3933
Mailing Address - Fax:803-818-3933
Practice Address - Street 1:3555 HARDEN STREET EXT STE 141
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6894
Practice Address - Country:US
Practice Address - Phone:803-818-3933
Practice Address - Fax:803-818-3933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-13
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty