Provider Demographics
NPI:1568451904
Name:KIRKPATRICK, DAVID L (OD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
Last Name:KIRKPATRICK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 MARGARET ST
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-1755
Mailing Address - Country:US
Mailing Address - Phone:518-566-2020
Mailing Address - Fax:518-561-5390
Practice Address - Street 1:450 MARGARET ST
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-1755
Practice Address - Country:US
Practice Address - Phone:518-566-2020
Practice Address - Fax:518-561-5390
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT003613152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
400635OtherMVP SELECT CARE
3613OtherWC
T0036131OtherTHERAPEUTIC
NY000470755001OtherBLUE SHIELD OF NORTHEASTE
107286OtherBC UTICA
NYC25061OtherEMPIRE BLUE CROSS
T003613OtherLICENSE
NY01790014Medicaid
NY01790014Medicaid
NYC25061OtherEMPIRE BLUE CROSS
3613OtherWC
NY01790014Medicaid