Basic Information
| Provider Information | |||||||||
| NPI: | 1639583859 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KIRCHNER | ||||||||
| FirstName: | IAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2325 W ARBORS DR STE 201 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282622664 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7042953500 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2325 W ARBORS DR STE 201 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28262 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7042953500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2014 | ||||||||
| LastUpdateDate: | 05/22/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | P30103 | MD | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207W00000X | 60908 | CT | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | 2019-01287 | NC | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.