Provider Demographics
NPI:1386693695
Name:KIRKPATRICK, PALMER MORGAN JR (MD)
Entity type:Individual
Prefix:
First Name:PALMER
Middle Name:MORGAN
Last Name:KIRKPATRICK
Suffix:JR
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 1:619 S DARGAN ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-2555
Mailing Address - Country:US
Mailing Address - Phone:843-662-7828
Mailing Address - Fax:843-665-1303
Practice Address - Street 1:619 S DARGAN ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2555
Practice Address - Country:US
Practice Address - Phone:843-662-7828
Practice Address - Fax:843-665-1303
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6311207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC06311Medicaid
SC06311Medicaid
SCC67169Medicare UPIN