Provider Demographics
NPI:1881748093
Name:BARRON, KIRK JOHN (DC)
Entity type:Individual
Prefix:DR
First Name:KIRK
Middle Name:JOHN
Last Name:BARRON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9859 BIG BEND BLVD
Mailing Address - Street 2:1 PLAZA LEVEL
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-6581
Mailing Address - Country:US
Mailing Address - Phone:314-909-0404
Mailing Address - Fax:314-909-0603
Practice Address - Street 1:9859 BIG BEND BLVD
Practice Address - Street 2:1 PLAZA LEVEL
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-6581
Practice Address - Country:US
Practice Address - Phone:314-909-0404
Practice Address - Fax:314-909-0603
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007000976111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor