Provider Demographics
NPI:1487677662
Name:KIRBY EYE ASSOCIATES, O.D., P.L.L.C.
Entity Type:Organization
Organization Name:KIRBY EYE ASSOCIATES, O.D., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:KIRBY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:252-353-3937
Mailing Address - Street 1:1913 E FIRE TOWER RD STE B
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-4127
Mailing Address - Country:US
Mailing Address - Phone:252-353-3937
Mailing Address - Fax:252-353-3931
Practice Address - Street 1:1913 E FIRE TOWER RD STE B
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-4127
Practice Address - Country:US
Practice Address - Phone:252-353-3937
Practice Address - Fax:252-353-3931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1814152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3150770OtherCIGNA HEALTHCARE
NC093E9OtherBCBS-NC
NCNC1814OtherEYEMED
NC89093E9Medicaid
NC189296OtherMEDCOST
NC5507604OtherAETNA
NC5812930001OtherCIGNA GOVERNMENT SERVICES
53937OtherDAVIS VISION
NC2325602Medicare PIN
NC093E9OtherBCBS-NC
NC5812930001OtherCIGNA GOVERNMENT SERVICES