KIRK MEDICAL CLINIC (NPI# 1982811543) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1982811543 |
Entity Type | Organization |
Organization Name | KIRK MEDICAL CLINIC |
Practice Address |
1102 West South St Suite B Benton AR 72015 |
Practice Telephone | 5017768545 |
Practice Fax Number | 5017761619 |
Mailing Telephone | 5017768545 |
Mailing Fax Number | 5017761619 |
Enumeration Date | 2007-05-16 |
Last Update Date | 2010-11-03 |
Authorized Official Name | MARVIN N. KIRK (OWNER) |
Authorized Official Telephone | 5017768545 |
Authorized Official Credential | M.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208D00000X | General Practice | C4039 | AR | Allopathic & Osteopathic Physicians |
Street Address |
1102 WEST SOUTH ST SUITE B |
City | BENTON |
State | AR |
Zip Code | 72015 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790343135 | Justin King | Case Manager/Care Coordinator | 1502 Mary Kay Blv6, Benton, AR 72015 | 2019-05-31 |
1790253326 | Seth Alexander Weisheit | Nurse Practitioner | 824 Military Road, Benton, AR 72015 | 2018-11-13 |
1396269627 | Abby G Sims | Speech-Language Pathologist | 3391 Peachtree Lane, Benton, AR 72015 | 2017-07-28 |
1225551278 | Jessica R Poe | Case Manager/Care Coordinator | 1502 Marykay Blvd, Benton, AR 72015 | 2017-07-21 |
1003357997 | Jamaal Langston | Case Manager/Care Coordinator | 1502 Mark Kay Blvd, Benton, AR 72015 | 2017-03-13 |
1881138550 | Shannon Gachot-ridgley | Counselor | 205 South Street Suite 3, Benton, AR 72015 | 2016-12-14 |
1295104578 | Excel Health of Haskell, Pllc | Clinical Nurse Specialist | 6029 Us Hwy 67, Haskell, AR 72015 | 2015-09-17 |
1528464054 | Kacey Jo Kiker | Nurse Practitioner | 620 W South St, Benton, AR 72015 | 2014-11-11 |
1700218252 | Jamie Brunt | Licensed Practical Nurse | 1718 Old Hot Springs Rd, Benton, AR 72015 | 2013-08-07 |
1760738942 | Kari J Richards | Physical Therapist | 5701 Springhill Rd, Bryant, AR 72015 | 2012-07-25 |
Find all providers in zip 72015 |
Taxonomy Code | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033507439 | Epoch Health- Benton, Pllc. | General Practice | 5 Medical Park Dr, Benton, AR 72015-3729 | 2015-01-07 |
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1083269690 | University of Arkansas At Monticello | General Practice | 663 University Drive, Monticello, AR 71656 | 2019-08-09 |
1912492786 | Chelsea Brown | General Practice | 6309 Highway 5 N, Bryant, AR 72022-8506 | 2018-06-25 |
1205345154 | Lakeside Walk-in Clinic Pllc | General Practice | 2230 Malvern Ave Ste E, Hot Springs, AR 71901-8000 | 2017-09-22 |
1558897595 | Epoch-nwa Pllc | General Practice | 5100 W Pauline Whitaker Pkwy, Ste. 110, Rogers, AR 72758-8335 | 2017-05-11 |
1023540655 | Aaron M Smith | General Practice | Varner Unit State Hwy 388, Gould, AR 71643 | 2017-04-02 |
1942749148 | Reece Lewis Crow | General Practice | 34 Windsor Road, Little Rock, AR 72212 | 2017-02-21 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.