Provider Demographics
NPI:1679828750
Name:KIRKLAND, THOMAS ALEXANDER JR (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ALEXANDER
Last Name:KIRKLAND
Suffix:JR
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 1:2 LADSON ST
Mailing Address - Street 2:APT. A
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-2757
Mailing Address - Country:US
Mailing Address - Phone:843-723-3572
Mailing Address - Fax:
Practice Address - Street 1:2 LADSON ST
Practice Address - Street 2:APT. A
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-2757
Practice Address - Country:US
Practice Address - Phone:843-723-3572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5156208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology