# GARY EDWARD KIRK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1154440477
- **Gender:** Man
- **Credential:** DPH

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 183500000X | Pharmacist | PHA.0022602 | CO | Yes |

## Other

- **Enumeration date:** 03/28/2007
- **Last updated:** 08/30/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 22602 | — | CO |