Provider Demographics
NPI:1164426730
Name:MURDOCK, KIRK A (MD)
Entity type:Individual
Prefix:DR
First Name:KIRK
Middle Name:A
Last Name:MURDOCK
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 1:210 N MAIN ST
Mailing Address - Street 2:SUITE 144
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-4003
Mailing Address - Country:US
Mailing Address - Phone:336-992-9637
Mailing Address - Fax:336-992-9638
Practice Address - Street 1:210 N MAIN ST
Practice Address - Street 2:SUITE 144
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-4003
Practice Address - Country:US
Practice Address - Phone:336-992-9637
Practice Address - Fax:336-992-9638
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101054116207W00000X
NC9600125207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA000123C79OtherVA MEDICARE PROVIDER #
NC14115OtherPARTNERS PROVIDER #
NC61278OtherMEDCOST PROVIDER #
VA006303382OtherVA MEDICAID PROVIDER #
NC11608OtherOPTICARE PROVIDER #
VA240691OtherANTHEM BCBS PROVIDER #
NC180029126OtherRR MEDICARE PROVIDER #
NC278833OtherMAMSI PROVIDER #
NC4310482OtherAETNA PROVIDER #
NC61401OtherNC BCBS PROVIDER #
NC8961401Medicaid
NC61278OtherMEDCOST PROVIDER #
VA006303382OtherVA MEDICAID PROVIDER #
NC180029126OtherRR MEDICARE PROVIDER #