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NPI Code Detail

MEDICARE: MR. THOMAS K KIRKLAND JR.

MEDICARE: MR. THOMAS K KIRKLAND JR.
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1639357619
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. THOMAS K KIRKLAND JR.
Provider Business Mailing Address
First Line : 1760 SW 3RD ST
Second Line :
City : CORVALLIS
State : OR
Zip : 97333-1725
Country : US
Telephone Number : 541-207-3773
Fax Number : 800-549-1017
Provider Business Practice Location Address
First Line : 1760 SW 3RD ST
Second Line :
City : CORVALLIS
State : OR
Zip : 97333-1725
Country : US
Telephone Number : 541-207-3773
Fax Number : 800-549-1017
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2008
Last Update Date : 03/04/2015

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