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Individual

MARTHA W KIRK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1821 S STOUGHTON RD, MADISON, WI 53716-2257
(608) 260-6000
(608) 260-6289
Mailing address
1821 S STOUGHTON RD, MADISON, WI 53716-2257
(608) 260-6000
(608) 260-6289

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3248-23
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1750686457
WI
Enumeration date
01/11/2011
Last updated
11/02/2015
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