Individual
BRANT EVAN KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1200
Mailing address
PO BOX 31001-0698, PASADENA, CA 91110-0001
(602) 263-1200
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
52882
AZ
Other
Enumeration date
04/08/2011
Last updated
08/23/2016
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