Provider Demographics
NPI:1659484681
Name:KIRN, DAVID S (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:KIRN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2376 ALEXANDRIA DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3229
Mailing Address - Country:US
Mailing Address - Phone:859-296-3195
Mailing Address - Fax:859-296-0397
Practice Address - Street 1:2376 ALEXANDRIA DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3229
Practice Address - Country:US
Practice Address - Phone:859-296-3195
Practice Address - Fax:859-296-0397
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY29775208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64297757Medicaid
KY000000049734OtherANTHEM BCBS PROV NUMBER
KY64297757Medicaid
KYF96576Medicare UPIN