Provider Demographics
NPI:1548279532
Name:KIRBY, ROLF EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:ROLF
Middle Name:EDWARD
Last Name:KIRBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 248 111 6TH STREET
Mailing Address - Street 2:LINCOLN COMMUNITY HOSPITAL
Mailing Address - City:HUGO
Mailing Address - State:CO
Mailing Address - Zip Code:80821-2002
Mailing Address - Country:US
Mailing Address - Phone:719-743-2421
Mailing Address - Fax:
Practice Address - Street 1:111 6TH STREET
Practice Address - Street 2:LINCOLN COMMUNITY HOSPITAL
Practice Address - City:HUGO
Practice Address - State:CO
Practice Address - Zip Code:80821-2002
Practice Address - Country:US
Practice Address - Phone:719-743-2421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO40973207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COH90097Medicare UPIN