Individual
KIRK L OHANIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
815 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2294
(817) 321-0404
Mailing address
1320 S UNIVERSITY DR STE 500, FORT WORTH, TX 76107-5732
(817) 321-0404
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G79344
CA
2085R0202X
Diagnostic Radiology Physician
V4452
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G793440
BLUE SHIELD
CA
05
—
00G793440
—
CA
01
—
00G793440159
CALOPTIMA
CA
Enumeration date
05/10/2006
Last updated
02/18/2025
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