MEDICARE: DR. CHRISTOPHER B. KIRBY MD

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
1	207R00000X	Internal Medicine Physician	ME135984	FL
2	207R00000X	Internal Medicine Physician	8450	NH
3	207RA0401X	Addiction Medicine (Internal Medicine) Physician	ME135984	FL
4	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician	TRN22146	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568456408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER B. KIRBY MD

Provider Business Mailing Address
First Line	:	2224 PANTUCKET DR
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33543-5149
Country	:	US
Telephone Number	:	603-247-7300
Fax Number	:

Provider Business Practice Location Address
First Line	:	2011 N WHEELER ST
Second Line	:
City	:	PLANT CITY
State	:	FL
Zip	:	33563-1860
Country	:	US
Telephone Number	:	813-756-5666
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	03/22/2019

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