Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 14532 | OK |
NPI | 1073567921 |
---|---|
Provider Name | Dr. James L Kirk JR. |
First Address | Oklahoma City, OK 73120-8380 |
Second Address | Oklahoma City, OK 73120-8380 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2006 |
Last Update Date | 09/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100100100A | (05) | OK |
D42558 | (02) |