Individual
EUGENE BRENT KIRKLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5300 FAR HILLS AVENUE, DAYTON, OH 45429-2347
(937) 291-8814
(937) 433-4043
Mailing address
5300 FAR HILLS AVENUE, DAYTON, OH 45429-2347
(937) 433-7536
(937) 433-9612
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
35120684
OH
207ND0101X
MOHS-Micrographic Surgery Physician
35120684
OH
207NS0135X
Procedural Dermatology Physician
35120684
OH
207NS0135X
Procedural Dermatology Physician
MD445143
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000823202
ANTHEM BC/BS
OH
01
—
3264729
CIGNA
OH
01
—
4905679
AETNA
OH
Enumeration date
09/16/2008
Last updated
06/08/2017
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