Individual
CLEMENT STOKES KIRKLAND JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
425 W 20TH ST, SUITE 1, NORFOLK, VA 23517-2128
(757) 622-6520
(757) 622-7205
Mailing address
425 W 20TH ST, SUITE 1, NORFOLK, VA 23517-2128
(757) 622-6520
(757) 622-7205
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101034390
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005618622
—
VA
01
—
11048
OPTIMA HEALTH
—
01
—
432130
BLUE CROSS BLUE SHIELD
—
Enumeration date
01/25/2007
Last updated
11/15/2013
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