Individual
DR. MARK KIRK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18701 N 67TH AVE, GLENDALE, AZ 85308-7100
(623) 561-1000
Mailing address
4722 E BELL RD # R2141, PHOENIX, AZ 85032-2314
(973) 800-2830
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
70907
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2020
Last updated
08/23/2023
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