Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 00019224 | AL |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 00019224 | AL |
NPI | 1013956697 |
---|---|
Provider Name | Dr. Dale Scott Kirby JR. |
First Address | Mobile, AL 36608-6705 |
Second Address | Mobile, AL 36608-6705 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 11/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0125474 | (05) | MS |
051505419 | (05) | AL |
515-05419 | BLUE CROSS BLUE SHIELD (01) | AL |
G29887 | (02) | AL |