Organization
ANTHONY J KIRK DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAT GILLMAN (OFFICE MANAGER)
(616) 949-1524
Entity
Organization
Contact information
Practice address
2050 BRETON RD SE, GRAND RAPIDS, MI 49546-5547
(616) 949-1524
(616) 949-9472
Mailing address
2050 BRETON RD SE, GRAND RAPIDS, MI 49546-5547
(616) 949-1524
(616) 949-9472
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
AK400050
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4355335
—
MI
01
—
4854111170
BCBS
—
Enumeration date
09/27/2010
Last updated
09/27/2010
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