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Individual

DR. KIRK JOSEPH AGERSON

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2849 MICHIGAN ST NE, SUITE 102, GRAND RAPIDS, MI 49506-1216
(616) 285-6450
(616) 285-6455
Mailing address
2849 MICHIGAN ST NE, SUITE 102, GRAND RAPIDS, MI 49506-1216
(616) 285-6450
(616) 285-6455

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301041396
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0804100171
BLUE CROSS BLUE SHIELD
MI
Enumeration date
09/23/2005
Last updated
07/08/2007
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