Individual
KEITH KIRBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3568 CHERE CAROL RD, HUMBOLDT, TN 38343-3639
(731) 784-7602
(731) 784-9518
Mailing address
PO BOX 400, JACKSON, TN 38302-0400
(731) 423-8697
(731) 422-5743
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD20878
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3055030
—
TN
Enumeration date
03/14/2006
Last updated
11/29/2012
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