Provider Demographics
NPI:1861561623
Name:JAMES M KIRBY AND JOSEPH J FEDORCHIK
Entity type:Organization
Organization Name:JAMES M KIRBY AND JOSEPH J FEDORCHIK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:KIRBY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:979-776-0750
Mailing Address - Street 1:2700 E 29TH ST
Mailing Address - Street 2:SUITE 240
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-2531
Mailing Address - Country:US
Mailing Address - Phone:979-776-0750
Mailing Address - Fax:979-774-0001
Practice Address - Street 1:2700 E 29TH ST
Practice Address - Street 2:SUITE 240
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2531
Practice Address - Country:US
Practice Address - Phone:979-776-0750
Practice Address - Fax:979-774-0001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty