Basic Information
| Provider Information | |||||||||
| NPI: | 1568547180 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JAMISON | ||||||||
| FirstName: | KIMBERLY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1600 E BROADWAY | ||||||||
| Address2: | BOX #41 | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MO | ||||||||
| PostalCode: | 65201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5738158000 | ||||||||
| FaxNumber: | 5738152638 | ||||||||
| Practice Location | |||||||||
| Address1: | 1600 E BROADWAY | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | MO | ||||||||
| PostalCode: | 652015844 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5738158000 | ||||||||
| FaxNumber: | 5738152638 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2006 | ||||||||
| LastUpdateDate: | 12/04/2012 | ||||||||
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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 | 207RN0300X | MD36616 | MO | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.