Individual provider · NPI-1

Dr. Kimberly Ann Funches-Jackson, M.D.

Family Medicine · Phenix City, AL

NPI number1497705123
StatusActive
Last updated in NPPESFeb 27, 2017

Details

NPI
1497705123
Entity type
Individual (NPI-1)
Name
Dr. Kimberly Ann Funches-Jackson
Credential
M.D.
Sex
Female
Sole proprietor
No
Enumeration date
May 11, 2006
Last updated
Feb 27, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine056705GAYes

Practice location

1810 Stadium Dr
Suite 210
Phenix City, AL 36867-3177

Phone 334-297-1085

Mailing address

Po Box 1045
Phenix City, AL 36868-1045

Phone 334-291-5255

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Family Medicine providers in Phenix City, AL