| Doctor Name: | DR. KIMMY GOYAL |
| NPI Number: | 1083895395 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 57-013906 |
| Business Practice Address: | 4879 Us Route 68 South West Liberty, OH - 43357 |
| Business Phone Number: | 9374650080 |
| Business Fax Number: | |
| Mailing Address: | 427 Kent Dr, Apt 6 BELLEFONTAINE |
| State: | OH |
| Postal Code: | 433119054 |
| Phone Number: | 9375392216 |
| Fax Number: | |
| NPI Enumeration Date: | 11/15/2007 |
| NPI Last Update Date: | 11/15/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | 57-013906 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |