Provider Demographics
NPI:1477226603
Name:KIRBY, CATHERINE (OD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:
Last Name:KIRBY
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2070 SAM RITTENBERG BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-4605
Mailing Address - Country:US
Mailing Address - Phone:843-852-9691
Mailing Address - Fax:843-852-4870
Practice Address - Street 1:2070 SAM RITTENBERG BLVD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-4605
Practice Address - Country:US
Practice Address - Phone:843-852-9691
Practice Address - Fax:843-852-4870
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-24
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCOPT.2288152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist