Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 8450 | NH |
N | 111NI0900X | Internist | 8450 | NH |
N | 207R00000X | Internist | ME135984 | FL |
N | 111NI0900X | Internist | ME135984 | FL |
N | 207RA0401X | Internist - Addiction Medicine | ME135984 | FL |
NPI | 1568456408 |
---|---|
Provider Name | Dr. Christopher B. Kirby |
First Address | Wesley Chapel, FL 33543-5149 |
Second Address | Plant City, FL 33563-1860 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2005 |
Last Update Date | 22/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
80001354 | (05) | NH |
E36004 | (02) | NH |