KIRK MEDICAL CLINIC; NPI #1982811543

Contact Information

KIRK MEDICAL CLINIC

1102 WEST SOUTH ST SUITE B
BENTON, AR 72015

Phone: 501-776-8545
Fax: 501-776-1619
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	General Practice	208D00000X	99	Physician/Undefined Physician type[6]

Indicates primary specialty

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NPI Profile & details for KIRK MEDICAL CLINIC

NPI Number 1982811543

LBN Legal business name KIRK MEDICAL CLINIC

Authorized official MARVIN KIRK - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 05/16/2007

Last updated 11/03/2010 - About 16 years ago

Identifiers

License #

C4039

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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