Individual
JACK M KIRICHIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
511 W GROVE ST, MIDDLEBORO, MA 02346-1458
(508) 923-6471
(508) 923-6474
Mailing address
511 W GROVE ST, MIDDLEBORO, MA 02346-1458
(508) 923-6471
(508) 923-6474
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
229852
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396037
AETNA
MA
05
—
2127491
—
MA
01
—
495484
TUFTS
—
Enumeration date
10/12/2006
Last updated
10/20/2016
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