Provider Demographics
NPI:1447365895
Name:KIRKLAND, KERRY LEWIS (MD)
Entity type:Individual
Prefix:
First Name:KERRY
Middle Name:LEWIS
Last Name:KIRKLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2018 BROOKWOOD MEDICAL CENTER DRIVE
Mailing Address - Street 2:SUITE G 5 PROFESSIONAL BLDG
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6898
Mailing Address - Country:US
Mailing Address - Phone:205-877-2900
Mailing Address - Fax:205-877-2904
Practice Address - Street 1:2018 BROOKWOOD MEDICAL CENTER DRIVE
Practice Address - Street 2:SUITE G 5 PROFESSIONAL BLDG
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6898
Practice Address - Country:US
Practice Address - Phone:205-877-2900
Practice Address - Fax:205-877-2904
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL8361207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL05661Medicaid
AL05661Medicare ID - Type Unspecified
AL05661Medicaid