Provider Demographics
NPI:1710197744
Name:MATCHETT, KIMBERLY L (MD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:L
Last Name:MATCHETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 HOSPITAL DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-1945
Mailing Address - Country:US
Mailing Address - Phone:276-634-0050
Mailing Address - Fax:276-634-0040
Practice Address - Street 1:315 HOSPITAL DR
Practice Address - Street 2:SUTIE 105
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-1945
Practice Address - Country:US
Practice Address - Phone:276-634-0050
Practice Address - Fax:276-634-0040
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101241213207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology