MEDICARE: DR. ROBERT WILLIAM KIRBY D.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
1	111N00000X	Chiropractor	3412	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	085M4	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1790867463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT WILLIAM KIRBY D.C.

Provider Business Mailing Address
First Line	:	1412 N BROADWAY
Second Line	:	SUITE 206
City	:	LEXINGTON
State	:	KY
Zip	:	40505-3157
Country	:	US
Telephone Number	:	859-543-0252
Fax Number	:	859-543-0698

Provider Business Practice Location Address
First Line	:	1412 N BROADWAY
Second Line	:	SUITE 206
City	:	LEXINGTON
State	:	KY
Zip	:	40505-3157
Country	:	US
Telephone Number	:	859-543-0252
Fax Number	:	859-543-0698

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	03/25/2014

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