Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 452 | NC |
N | 213ES0103X | Foot & Ankle Surgery | 452 | NC |
N | 213ES0131X | Foot Surgery | 452 | NC |
NPI | 1467425348 |
---|---|
Provider Name | Dr. Joseph F Kibler |
First Address | Supply, NC 28462-4088 |
Second Address | Supply, NC 28462-4088 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2006 |
Last Update Date | 30/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5199990001 | MEDICARE DMERC PTAN (01) | NC |
890806X | (05) | NC |
U87970 | (02) | NC |