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Individual

MR. LAWRENCE F KIRK JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 HIGHWAY 49 SOUTH, BYRON, GA 31008-6937
(478) 956-2648
(478) 956-4080
Mailing address
200 HIGHWAY 49 SOUTH, BYRON, GA 31008-6937
(478) 956-2648
(478) 956-4080

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
042072
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000772021J
GA
01
P00300958
RAILROAD MEDICARE
GA
Enumeration date
09/15/2005
Last updated
11/02/2012
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