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General NPI Number Information
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NPI Number | 1023289188
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Entity Type | Organization
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Legal Business Name | JOHN J KIRKLAND MD PA
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Dates
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Enumeration Date | 03/17/2008
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 110 W PINE ST
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City | FLORENCE
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State | SC
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Zip | 29501-4712
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Country | US
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Telephone | 843-662-8468
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Fax | 843-662-8469
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Provider Business Mailing Address
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Address Line | 110 W PINE ST
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City | FLORENCE
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State | SC
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Zip | 29501-4712
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Country | US
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Telephone | 843-662-8468
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Fax | 843-662-8469
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Authorized Official
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Title or Position | PHYSICIAN
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Name | JOHN J KIRKLAND
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Credential | MD
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Telephone | 843-662-8468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 6401
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License Number State | SC
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