Healthcare Provider Details

I. General information

NPI: 1578940029
Provider Name (Legal Business Name): ROBERT SPENCER KIRKLAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2015
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 MICHIGAN ST NE STE 1100
GRAND RAPIDS MI
49503-2562
US

IV. Provider business mailing address

PO BOX 3525
EVANSVILLE IN
47734-3525
US

V. Phone/Fax

Practice location:
  • Phone: 616-486-5750
  • Fax:
Mailing address:
  • Phone: 512-583-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number4301504790
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: