Provider Demographics
NPI:1588611586
Name:KIRKLAND, KARL (PHD)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:
Last Name:KIRKLAND
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8650 MINNIE BROWN RD
Mailing Address - Street 2:SUITE 116
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7803
Mailing Address - Country:US
Mailing Address - Phone:334-215-4466
Mailing Address - Fax:334-215-4469
Practice Address - Street 1:8650 MINNIE BROWN RD
Practice Address - Street 2:SUITE 116
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-7803
Practice Address - Country:US
Practice Address - Phone:334-215-4466
Practice Address - Fax:334-215-4469
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL341103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000072588OtherUAB LEGACY # FOR BC & MC
AL102I687966OtherMEDICARE
AL890007150Medicaid
AL166424Medicaid
R35957Medicare UPIN
R35957Medicare UPIN