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General NPI Number Information
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NPI Number | 1740461763
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Entity Type | Organization
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Legal Business Name | CLEM KIRKLAND, M.D., INC
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Dates
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Enumeration Date | 11/19/2007
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Last Update Date | 09/26/2010
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Provider Practice Location Address
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Address Line | 5928 SPRINGBORO PIKE
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City | DAYTON
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State | OH
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Zip | 45449-3250
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Country | US
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Telephone | 937-433-0220
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Fax |
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Provider Business Mailing Address
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Address Line | 5928 SPRINGBORO PIKE
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City | DAYTON
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State | OH
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Zip | 45449-3250
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Country | US
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Telephone | 937-433-0220
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CLEM KIRKLAND
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Credential | M.D.
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Telephone | 937-433-0220
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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 |
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License Number State |
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