NPI 1043988116

Tanner C Kimble, CSTCSFA

Practitioner Surgical Assistant Vicksburg, MS

Practice location

Address: 2100 Highway 61 N, Vicksburg, MS 39183-8211
Phone: (601) 883-5000
Mailing address: 406 Lacasa Loop, Twin Falls, ID 83301-5663

Registered specialties

Surgical Assistant Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 246ZC0007X Licence 188016

Other Specialist/Technologist, Other providers in Mississippi →

Registry record

NPI: 1043988116
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 Sep 2021
Record last updated: 15 Feb 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.