Provider Demographics
NPI:1053308783
Name:KIRBY, CHARLES GENTRY (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:GENTRY
Last Name:KIRBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:70 WESTCARE DR
Mailing Address - Street 2:STE 403
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-5292
Mailing Address - Country:US
Mailing Address - Phone:828-586-7462
Mailing Address - Fax:828-586-3312
Practice Address - Street 1:70 WESTCARE DR
Practice Address - Street 2:STE 403
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-5292
Practice Address - Country:US
Practice Address - Phone:828-586-7462
Practice Address - Fax:828-586-3312
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-27
Last Update Date:2008-07-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC19614207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1033YOtherBCBS
NC89-135HYMedicaid
NC1033YOtherBCBS
NC2232900BMedicare PIN