Individual
DR. STEPHEN L KIRKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1111 TENEYCK ST, SUITE 100, JACKSON, MI 49201-2461
(517) 787-8940
(517) 787-9054
Mailing address
1111 TENEYCK ST, SUITE 100, JACKSON, MI 49201-2461
(517) 787-8940
(517) 787-9054
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
5101007908
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0453800108
BLUE CROSS
MI
01
—
1359429
FIRST HEALTH
MI
05
—
3488032
—
MI
01
—
5284809
AETNA
MI
01
—
SK007908
LICENSE NUMBER
MI
Enumeration date
10/18/2005
Last updated
03/28/2021
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