Individual
KIRK STEVEN DUTTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1316 WASHINGTON AVE, WACO, TX 76701-1129
(254) 776-1421
(254) 776-1711
Mailing address
1316 WASHINGTON AVE, WACO, TX 76701-1129
(254) 776-1421
(254) 776-1711
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
E9613
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000LM23
BCBS OF TEXAS
TX
01
—
007250000
MAGELLAN BEHAVIORAL
TX
05
—
034725401
—
TX
01
—
282857
VALUE OPTIONS
TX
Enumeration date
08/11/2005
Last updated
09/22/2011
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