Individual
JAMES CLARK IRCINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1050 E BROADWAY, MONONA, WI 53716-4023
(608) 222-8779
(608) 222-8944
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
71728
WI
207Q00000X
Family Medicine Physician
Primary
71728-20
WI
208M00000X
Hospitalist Physician
71728-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023545886
—
WI
Enumeration date
05/11/2017
Last updated
09/22/2021
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