Individual
DR. JOHN WILLIAM DIRCKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 JOHN ST, BOX 74, KALAMAZOO, MI 49007-5341
(269) 341-8481
(269) 341-7781
Mailing address
601 JOHN ST, BOX 42, KALAMAZOO, MI 49007-5341
(269) 341-7806
(269) 341-8743
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
JD028898
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
108097
GRT LAKES HLTH PLAN
—
05
—
1386445
—
MI
01
—
290390908
BCBS IND PIN
—
01
—
290C913410
BCBS GRP PIN
—
01
—
290C96034
BC/BS OF MICHIGAN
MI
01
—
382356205105
COMMUNITY CHOICE OF MICH
MI
01
—
4379449
AETNA
—
01
—
4809116
PHP
—
01
—
4830033
PHP
MI
05
—
4991610
—
MI
01
—
P54696
BLUECARE NETWORK
MI
Enumeration date
09/12/2006
Last updated
09/11/2009
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