Provider Demographics
NPI:1407260854
Name:KIRBY, DEREK T (DO)
Entity Type:Individual
Prefix:DR
First Name:DEREK
Middle Name:T
Last Name:KIRBY
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:650 JOEL DR
Mailing Address - Street 2:BLANCHFIELD ARMY COMMUNITY HOSPITAL
Mailing Address - City:FORT CAMPBELL
Mailing Address - State:KY
Mailing Address - Zip Code:42223-5318
Mailing Address - Country:US
Mailing Address - Phone:270-461-4793
Mailing Address - Fax:270-412-4151
Practice Address - Street 1:650 JOEL DR
Practice Address - Street 2:BLANCHFIELD ARMY COMMUNITY HOSPITAL
Practice Address - City:FORT CAMPBELL
Practice Address - State:KY
Practice Address - Zip Code:42223-5318
Practice Address - Country:US
Practice Address - Phone:270-461-4793
Practice Address - Fax:270-412-4151
Is Sole Proprietor?:No
Enumeration Date:2014-06-13
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN2927208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice