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General NPI Number Information
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NPI Number | 1114991916
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Entity Type | Individual
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Provider Name | JOHN AARON KIRK PA-C
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Gender | Male
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Dates
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Enumeration Date | 02/16/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 5825 PLANK RD
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City | FREDERICKSBURG
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State | VA
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Zip | 22407-5207
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Country | US
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Telephone | 540-785-3448
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Fax |
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Provider Business Mailing Address
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Address Line | 549 GRAPHITE TRL
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City | CHESAPEAKE
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State | VA
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Zip | 23320-3439
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Country | US
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Telephone | 910-813-3876
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110840725
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License Number State | VA
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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 | 0010-00517
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License Number State | NC
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