Provider Demographics
NPI:1568732170
Name:KIRKLAND, MATTHEW LEVON (PHARMD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:LEVON
Last Name:KIRKLAND
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4334 VANCE DR
Mailing Address - Street 2:APT B3
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5649
Mailing Address - Country:US
Mailing Address - Phone:808-640-8623
Mailing Address - Fax:
Practice Address - Street 1:5600 DEBARR RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-2300
Practice Address - Country:US
Practice Address - Phone:907-339-7790
Practice Address - Fax:623-869-1301
Is Sole Proprietor?:No
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKPHAP 2070183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist