Provider Demographics
NPI:1083784854
Name:KIRKPATRICK, DOUGLAS P (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:P
Last Name:KIRKPATRICK
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Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:100 PARK STREET
Mailing Address - Street 2:GLENS FALLS HOSPITAL - CREDENTIALING
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-4413
Mailing Address - Country:US
Mailing Address - Phone:518-926-5924
Mailing Address - Fax:518-926-6983
Practice Address - Street 1:14 HUDSON AVENUE
Practice Address - Street 2:SURGICAL SPECIALISTS OF GLENS FALLS HOSPITAL - ORTHO
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801
Practice Address - Country:US
Practice Address - Phone:189-265-6005
Practice Address - Fax:518-926-5605
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2021-09-16
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Provider Licenses
StateLicense IDTaxonomies
NY202796207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01675305Medicaid
NY4108260001Medicare NSC
AA0798Medicare PIN
NY01675305Medicaid