# KIRK MEDICAL CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982811543
- **Authorized official:** MARVIN N. KIRK M.D. (OWNER)
- **Authorized official phone:** (501) 776-8545

## Contact information

- **Practice address:** 1102 WEST SOUTH ST SUITE B, BENTON, AR 72015
- **Practice address phone:** (501) 776-8545
- **Practice address fax:** (501) 776-1619
- **Mailing address:** 1102 WEST SOUTH ST SUITE B, BENTON, AR 72015
- **Mailing address phone:** (501) 776-8545
- **Mailing address fax:** (501) 776-1619

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | C4039 | AR | Yes |

## Other

- **Enumeration date:** 05/16/2007
- **Last updated:** 11/03/2010