Healthcare Provider Details

I. General information

NPI: 1760968465
Provider Name (Legal Business Name): KIRK MCCALMON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2018
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 GROVE ST
JERSEY CITY NJ
07302-5905
US

IV. Provider business mailing address

1 DIAMOND HILL RD
BERKELEY HEIGHTS NJ
07922-2104
US

V. Phone/Fax

Practice location:
  • Phone: 201-354-1957
  • Fax:
Mailing address:
  • Phone: 908-588-3635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA12000700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: