Provider Demographics
NPI:1477589513
Name:JAMES F. KIRK DPM,PA
Entity Type:Organization
Organization Name:JAMES F. KIRK DPM,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:KIRK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:704-786-4482
Mailing Address - Street 1:889 BRADLEY ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-2979
Mailing Address - Country:US
Mailing Address - Phone:704-786-4482
Mailing Address - Fax:
Practice Address - Street 1:889 BRADLEY ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2979
Practice Address - Country:US
Practice Address - Phone:704-786-4482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-23
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC318213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1477589513OtherGROUP NPI NUMBER
NC0546620001OtherDMERC PROVIDER NUMBER
NC0546620001OtherDMERC PROVIDER NUMBER