Physician Compare National (NPI:1750791182)

HEALTHCARE PROVIDER: KEVIN KIRK M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1750791182
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1951528538
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180201000083
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KIRK
	Individual professional last name
Provider First Name	KEVIN
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF UTAH SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2014
	Individual professional's medical school graduation year
Primary Specialty	OPHTHALMOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	380 E 800
	Group Practice or individual's line 1 address
City	RICHFIELD
	Group Practice or individual's city
State	UT
	Group Practice or individual's state
Zip Code	847011913
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	460026
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SEVIER VALLEY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	461303
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SANPETE VALLEY HOSPITAL - CAH
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	461306
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	GUNNISON VALLEY HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y