Organization
ENT ASSOCIATES OF JACKSON, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN L KIRKNER D.O. (CO-OWNER)
(517) 787-8940
Entity
Organization
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
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0C81026
BLUE CROSS GROUP
MI
01
—
CI5670
MEDICARE RAILROAD
MI
Enumeration date
09/26/2006
Last updated
02/29/2008
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