Healthcare Provider Details

I. General information

NPI: 1891158333
Provider Name (Legal Business Name): KIRBY WALKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2016
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 HOSPITAL DR
YORK ME
03909-1011
US

IV. Provider business mailing address

16 HOSPITAL DR
YORK ME
03909-1011
US

V. Phone/Fax

Practice location:
  • Phone: 207-363-4321
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberMD26989
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: