Provider Demographics
NPI:1114931508
Name:KIRKLING, KEVIN CORBIN (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:CORBIN
Last Name:KIRKLING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 SPRING MILL CT
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46158-1790
Mailing Address - Country:US
Mailing Address - Phone:317-831-3877
Mailing Address - Fax:317-831-4748
Practice Address - Street 1:30 SPRING MILL CT
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46158-1790
Practice Address - Country:US
Practice Address - Phone:317-831-3877
Practice Address - Fax:317-831-4748
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN080000626A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000085957OtherANTHEM
T34940Medicare UPIN
IN00000561930Medicare PIN