Provider Demographics
NPI:1073567921
Name:KIRK, JAMES L JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:KIRK
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:13313 N MERIDIAN AVE
Mailing Address - Street 2:BLDG D
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8380
Mailing Address - Country:US
Mailing Address - Phone:405-529-5759
Mailing Address - Fax:405-529-5760
Practice Address - Street 1:13313 N MERIDIAN AVE
Practice Address - Street 2:BLDG D
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8380
Practice Address - Country:US
Practice Address - Phone:405-529-5759
Practice Address - Fax:405-529-5760
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2015-12-09
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Provider Licenses
StateLicense IDTaxonomies
OK14532207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100100100AMedicaid
OK100100100AMedicaid