| Doctor Name: | ROGER LEE KIRKWOOD |
| NPI Number: | 1063728764 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ARNP |
| License Number: | 5375194031 |
| Business Practice Address: | 8072 Normandy Dr Fort Riley, KS - 664427069 |
| Business Phone Number: | 7852405592 |
| Business Fax Number: | 7852405768 |
| Mailing Address: | 8072 Normandy Dr, FORT RILEY |
| State: | KS |
| Postal Code: | 664427069 |
| Phone Number: | 7852405592 |
| Fax Number: | 7852405768 |
| NPI Enumeration Date: | 08/19/2010 |
| NPI Last Update Date: | 05/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 5375194031 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |