Provider Demographics
NPI:1033117155
Name:KIRK, JAMES FREDERICK (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:FREDERICK
Last Name:KIRK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2215 NASHVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1105
Mailing Address - Country:US
Mailing Address - Phone:806-725-5844
Mailing Address - Fax:806-723-6532
Practice Address - Street 1:3612 23RD ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1326
Practice Address - Country:US
Practice Address - Phone:806-793-8787
Practice Address - Fax:806-793-0150
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE6118208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX116856104OtherFIRSTCARE
TX132893209Medicaid
TX345836YKT8OtherMEDICARE
NMU82223Medicaid
TX8EF229OtherBCBS