# MICHIANA UROLOGY PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851592935
- **Authorized official:** DR. KENT A KIRBY M.D. (OWNER PHYSICIAN)
- **Authorized official phone:** (269) 695-3897

## Contact information

- **Practice address:** 804 E FRONT ST, BUCHANAN, MI 49107-1444
- **Practice address phone:** (269) 695-3897
- **Practice address fax:** (269) 695-0460
- **Mailing address:** 804 E FRONT ST, BUCHANAN, MI 49107-1444
- **Mailing address phone:** (269) 695-3897
- **Mailing address fax:** (269) 695-0460

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 4301077717 | MI | Yes |

## Other

- **Enumeration date:** 05/29/2007
- **Last updated:** 08/22/2020