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General NPI Number Information
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NPI Number | 1427069475
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Entity Type | Individual
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Provider Name | DEBORAH T KIRK M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 01/16/2018
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Provider Practice Location Address
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Address Line | 100 SOUTH MAIN STREET SUITE 205
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City | SMYRNA
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State | DE
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Zip | 19977-1373
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Country | US
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Telephone | 302-653-6022
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Fax | 302-389-1094
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Provider Business Mailing Address
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Address Line | 100 SOUTH MAIN STREET SUITE 205
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City | SMYRNA
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State | DE
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Zip | 19977
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Country | US
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Telephone | 302-653-6022
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Fax | 302-389-1094
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C100006527
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License Number State | DE
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