Beryl Jeanette Kime, M.D.

Individual provider Active NPI Family Medicine Physician · Mount Vernon, MO

NPI 1528076122 · NPPES record last updated Nov 14, 2008

Key facts

NPI
1528076122
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
042103 (GA)
Practice address
600 N Main St
Mount Vernon, MO 65712-1004
Phone
(417) 466-0123
Fax
(417) 466-0199
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
042103GAMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 042103 GA Yes

Addresses

Primary practice location

600 N Main St
Mount Vernon, MO 65712-1004

Mailing address

600 N Main St
Mount Vernon, MO 65712-1004
Phone (417) 466-0123

Other providers in Mount Vernon, MO

All providers in Mount Vernon, MO · Family Medicine Physician in Missouri

Sources for this page

Verify at the official NPI Registry.