Provider Demographics
NPI:1487727970
Name:KIRK, DAREN L (DC)
Entity type:Individual
Prefix:DR
First Name:DAREN
Middle Name:L
Last Name:KIRK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12302 E 86TH ST N
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-2543
Mailing Address - Country:US
Mailing Address - Phone:918-272-6200
Mailing Address - Fax:918-274-3724
Practice Address - Street 1:8514 N 128TH EAST AVE
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-6242
Practice Address - Country:US
Practice Address - Phone:918-272-6200
Practice Address - Fax:918-274-3724
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3374111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK612649700OtherUS DEPT OF LABOR
OKOK700861OtherINDIVIDUAL PTAN
OK$$$$$$$$$002OtherBCBS
OKOK700861OtherINDIVIDUAL PTAN
OK612649700OtherUS DEPT OF LABOR