Smith, Kirk Macdonald
Smith, Kirk Macdonald is an individual health care provider with primary practice located at 19 Myrtle St , Medford OR 97504-7337. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Smith, Kirk Macdonald can be contacted via phone (541) 773-3863.Contact Information
Primary practice address
19 Myrtle St
Medford OR 97504-7337
Phone: (541) 773-3863
Fax: (541) 618-4413
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 200150032 | Oregon |
Profile Details
| NPI number | 1811994254 |
|---|---|
| LBN Legal business name | Smith, Kirk Macdonald |
| Credentials | MS, FNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2005 |
| Last updated | Sep 9th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811994254 | NPPES |
| Oregon | MEDICAID | 227698 |
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