Individual
DR. KIRK L SUSOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
325 E H ST, OSCAR G. JOHNSON VA MEDICAL CENTER, IRON MOUNTAIN, MI 49801-4760
(906) 774-3300
(906) 779-3124
Mailing address
325 E H ST, OSCAR G. JOHNSON VA MEDICAL CENTER, IRON MOUNTAIN, MI 49801-4760
(906) 774-3300
(906) 779-3124
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
4301039087
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4758301
—
MI
05
—
4777174
—
MI
Enumeration date
08/12/2005
Last updated
12/03/2013
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