Individual
CLINT FORREST KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
110 NW 31ST 2ND FLOOR, LAWTON, OK 73505
(580) 357-3671
(580) 357-1256
Mailing address
PO BOX 785, LAWTON, OK 73502
(580) 357-9984
(580) 357-3277
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
3331
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100169700B
—
OK
01
—
2012060
FIRST HEALTH
OK
01
—
5433409
FIRST HEALTH CCN
OK
01
—
731612928
PPO OK
OK
01
—
731612928001
BC/BS
OK
01
—
8608608002
CIGNA PPO
OK
01
—
P00007143
RR MEDICARE
OK
Enumeration date
06/21/2006
Last updated
01/21/2009
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