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NPI Code Detail

MEDICARE: DANIEL TERRELL KIRKLEY MMS. PA-C

MEDICARE: DANIEL TERRELL KIRKLEY MMS. PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMPA.2910SC
22086S0127XTrauma Surgery PhysicianMPA.2910SC
3363A00000XPhysician Assistant0010-08907NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245748045
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL TERRELL KIRKLEY MMS. PA-C
Provider Business Mailing Address
First Line : PO BOX 60447
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-0447
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7804 FAIRVIEW RD STE A
Second Line :
City : CHARLOTTE
State : NC
Zip : 28226-4999
Country : US
Telephone Number : 704-316-3136
Fax Number : 704-316-3140
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2018
Last Update Date : 02/13/2024

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