Provider Demographics
NPI:1609925734
Name:HARPER, KIRBY ALLEN (PAC)
Entity Type:Individual
Prefix:MR
First Name:KIRBY
Middle Name:ALLEN
Last Name:HARPER
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:289 IRELAND AVE
Mailing Address - Street 2:IRELAND ARMY COMMUNITY HOSPITALI
Mailing Address - City:FORT KNOX
Mailing Address - State:KY
Mailing Address - Zip Code:40121-5111
Mailing Address - Country:US
Mailing Address - Phone:502-624-0559
Mailing Address - Fax:502-624-0511
Practice Address - Street 1:289 IRELAND AVE
Practice Address - Street 2:IRELAND ARMY COMMUNITY HOSPITAL
Practice Address - City:FORT KNOX
Practice Address - State:KY
Practice Address - Zip Code:40121-5111
Practice Address - Country:US
Practice Address - Phone:502-624-0559
Practice Address - Fax:502-624-0511
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY365363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant