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NPI Code Detail

MEDICARE: DR. KEVIN LEE KIRK DO

MEDICARE: DR. KEVIN LEE KIRK DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery PhysicianH0063452MD
2207XX0004XOrthopaedic Foot and Ankle Surgery PhysicianN0893TX
3207XX0004XOrthopaedic Foot and Ankle Surgery Physician25MB09228900NJ

General Provider Information

NPI Number : 1316910490
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEVIN LEE KIRK DO
Provider Business Mailing Address
First Line : 1200 BROOKLYN AVE
Second Line : SUITE 320
City : SAN ANTONIO
State : TX
Zip : 78212-4803
Country : US
Telephone Number : 210-804-5690
Fax Number : 210-804-5693
Provider Business Practice Location Address
First Line : 1200 BROOKLYN AVE
Second Line : SUITE 320
City : SAN ANTONIO
State : TX
Zip : 78212-4803
Country : US
Telephone Number : 210-804-5690
Fax Number : 210-804-5693
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2006
Last Update Date : 11/19/2014

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Directions to “ DR. KEVIN LEE KIRK DO” Practice Location

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