Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | MD436381 | PA |
NPI | 1104969708 |
---|---|
Provider Name | Dr. Anthony J Kirby |
First Address | Bentleyville, PA 15314-1061 |
Second Address | Bentleyville, PA 15314-1061 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2007 |
Last Update Date | 30/07/2020 |