Provider Demographics
NPI:1558477471
Name:KIRBY, JAMES V (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:V
Last Name:KIRBY
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 1:2003 KOOTENAI HEALTH WAY
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-6051
Mailing Address - Country:US
Mailing Address - Phone:208-625-4000
Mailing Address - Fax:
Practice Address - Street 1:2005 N IRONWOOD PKWY STE 138
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2647
Practice Address - Country:US
Practice Address - Phone:208-202-2424
Practice Address - Fax:208-953-7896
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM107662084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT20-4550269OtherTIN
UTF90560Medicare UPIN
UT308056OtherDMBA
UT000011845Medicare ID - Type Unspecified
UT52081OtherPEHP
UT107006907105OtherSELECT HEALTH