Provider Demographics
NPI:1427093038
Name:JOBE, KIRK W (MD)
Entity type:Individual
Prefix:
First Name:KIRK
Middle Name:W
Last Name:JOBE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2995 DREW ST FL 2
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-3012
Mailing Address - Country:US
Mailing Address - Phone:727-315-7496
Mailing Address - Fax:
Practice Address - Street 1:620 10TH ST N STE 1D
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-1407
Practice Address - Country:US
Practice Address - Phone:727-828-8400
Practice Address - Fax:727-333-6435
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-18
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93476207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0909520001OtherPALMETTO MEDICARE DME
FL16982OtherBCBS
FLP00247400OtherRAILROAD MEDICARE
FL273085500Medicaid
FL273085500Medicaid
I37224Medicare UPIN