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Individual

PHILLIP DARRELL KIRKLAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
8115 BEAVER RIDGE RD, KNOXVILLE, TN 37931-3314
(865) 414-6654
Mailing address
8115 BEAVER RIDGE RD, KNOXVILLE, TN 37931-3314
(865) 414-6654

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1277
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1516699
TN
01
4177381
BLUECROSS BLUESHIELD
TN
Enumeration date
10/02/2007
Last updated
04/09/2014
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