Individual
DOUGLAS W KIRTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1970 ROANOKE BLVD, SALEM, VA 24153-6404
(540) 982-2463
(540) 855-3402
Mailing address
1970 ROANOKE BLVD, SALEM, VA 24153-6404
(540) 982-2463
(540) 855-3402
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
0101042557
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006097626
—
VA
01
—
100009139
MC RAILROAD
—
05
—
1235117904
—
VA
01
—
260854
ANTHEM
—
Enumeration date
01/04/2006
Last updated
09/21/2016
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