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General NPI Number Information
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NPI Number | 1033519780
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Entity Type | Individual
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Provider Name | SEAN JOSEPH KIRBY PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/31/2014
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 201 S A ST
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City | PENSACOLA
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State | FL
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Zip | 32502-5554
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Country | US
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Telephone | 850-934-7545
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Fax | 850-934-7972
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Provider Business Mailing Address
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Address Line | 201 S A ST
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City | PENSACOLA
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State | FL
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Zip | 32502-5554
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Country | US
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Telephone | 850-934-7545
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Fax | 850-934-7972
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 2279PA
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9111243
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2393
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License Number State | SC
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