Provider Demographics
NPI:1013114354
Name:KIRKPATRICK, THANH G (MD)
Entity Type:Individual
Prefix:DR
First Name:THANH
Middle Name:G
Last Name:KIRKPATRICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:THANH
Other - Middle Name:
Other - Last Name:GIANG BUI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 191
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:DE
Mailing Address - Zip Code:19723-0191
Mailing Address - Country:US
Mailing Address - Phone:302-651-4000
Mailing Address - Fax:302-651-4945
Practice Address - Street 1:130 S. BRYN MAWR AVE.
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3121
Practice Address - Country:US
Practice Address - Phone:610-526-3000
Practice Address - Fax:302-651-5938
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT190986208000000X
PAMD435479208M00000X, 208000000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice