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Individual

DANIEL TERRELL KIRKLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MMS. PA-C

Contact information

Practice address
7804 FAIRVIEW RD STE A, CHARLOTTE, NC 28226-4999
(704) 316-3136
(704) 316-3140
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MPA.2910
SC
2086S0127X
Trauma Surgery Physician
MPA.2910
SC
363A00000X
Physician Assistant
Primary
0010-08907
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3620PA
SC
Enumeration date
01/15/2018
Last updated
02/13/2024
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