| Doctor Name: | DR. DORLAN J. KIMBROUGH |
| NPI Number: | 1568661684 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | |
| Business Practice Address: | 1 Brookline Pl Suite 225 Brookline, MA - 024457224 |
| Business Phone Number: | 6177325500 |
| Business Fax Number: | |
| Mailing Address: | 1 Brookline Pl, Suite 225 BROOKLINE |
| State: | MA |
| Postal Code: | 024457224 |
| Phone Number: | 6177325500 |
| Fax Number: | |
| NPI Enumeration Date: | 07/18/2007 |
| NPI Last Update Date: | 07/26/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |