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General NPI Number Information
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NPI Number | 1275720492
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Entity Type | Individual
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Provider Name | PHILLIP DARRELL KIRKLAND P.A.
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Gender | Male
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Dates
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Enumeration Date | 10/02/2007
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Last Update Date | 04/09/2014
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Provider Practice Location Address
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Address Line | 8115 BEAVER RIDGE RD
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City | KNOXVILLE
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State | TN
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Zip | 37931-3314
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Country | US
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Telephone | 865-414-6654
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Fax |
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Provider Business Mailing Address
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Address Line | 8115 BEAVER RIDGE RD
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City | KNOXVILLE
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State | TN
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Zip | 37931-3314
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Country | US
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Telephone | 865-414-6654
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 1277
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License Number State | TN
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