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General NPI Number Information
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NPI Number | 1831172709
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Entity Type | Individual
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Provider Name | MATTHEW T KIRBY M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 01/07/2022
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Provider Practice Location Address
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Address Line | 5670 PEACHTREE DUNWOODY RD SUITE 1280
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City | ATLANTA
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State | GA
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Zip | 30342-1699
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Country | US
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Telephone | 404-257-1589
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Fax | 404-303-1950
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Provider Business Mailing Address
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Address Line | 3495 PIEDMONT RD NE ATTN:TOBIE SHELLEY
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City | ATLANTA
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State | GA
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Zip | 30305-1717
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Country | US
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Telephone | 404-365-0966
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 56730
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License Number State | GA
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