Individual
MR. J WILLIAM KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
34101 FARENHOLT AVE, SAN DIEGO, CA 92134-7000
(858) 539-5507
Mailing address
UNIT 100331 BOX 1, FPO, AE 09513-3100
(757) 443-8798
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
04/14/2015
Last updated
06/11/2018
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