| Walter R Kirby, PA-C | |
|
333 Revolutionary Trl, Fairfax, SC 29827-7109 | |
| (803) 632-2533 | |
| (803) 632-2451 |
| Full Name | Walter R Kirby |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 12 Years |
| Location | 333 Revolutionary Trl, Fairfax, South Carolina |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649414905 | NPI | - | NPPES |
| 2119PA | Medicaid | SC | |
| 2214 | Other | SC | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 2214 (South Carolina) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Centerwell Home Health | Walterboro, SC | Home health agency |
| Allendale County Hospital | Fairfax, SC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Low Country Health Care System Inc | 4284530940 | 33 |
| Entity Name | Low Country Health Care System Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053475566 PECOS PAC ID: 4284530940 Enrollment ID: O20031211000944 |
| Entity Name | Low Country Health Care System Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578659942 PECOS PAC ID: 4284530940 Enrollment ID: O20160524000583 |
| Entity Name | Low Country Health Care System Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235225608 PECOS PAC ID: 4284530940 Enrollment ID: O20160606001593 |
| Entity Name | Low Country Health Care System Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780112912 PECOS PAC ID: 4284530940 Enrollment ID: O20190610001031 |
| Entity Name | Low Country Health Care System Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306378310 PECOS PAC ID: 4284530940 Enrollment ID: O20200107003426 |
| Mailing Address | Practice Location Address |
|---|---|
| Walter R Kirby, PA-C 86 Wren St, Barnwell, SC 29812-1529 Ph: (803) 259-5762 | Walter R Kirby, PA-C 333 Revolutionary Trl, Fairfax, SC 29827-7109 Ph: (803) 632-2533 |
Sotheary Chan, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1787 Allendale Fairfax Hwy, Fairfax, SC 29827 Phone: 803-632-1176 Fax: 803-632-2410 |