Basic Information
| Provider Information | |||||||||
| NPI: | 1003857855 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KERRY KIRKMAN MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21216 NORTHWEST FWY | ||||||||
| Address2: | STE 520 | ||||||||
| City: | CYPRESS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774294695 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2819557900 | ||||||||
| FaxNumber: | 2819550700 | ||||||||
| Practice Location | |||||||||
| Address1: | 21216 NORTHWEST FWY | ||||||||
| Address2: | STE 520 | ||||||||
| City: | CYPRESS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774294695 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2819557900 | ||||||||
| FaxNumber: | 2819550700 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2006 | ||||||||
| LastUpdateDate: | 03/27/2008 | ||||||||
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| AuthorizedOfficialLastName: | KIRKMAN | ||||||||
| AuthorizedOfficialFirstName: | KERRY | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2819550700 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | L7776 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.