Organization

Anthony J Kirk Dpm Pc

Podiatric Clinic/Center in Grand Rapids, MI(View on Map)

Legal Business Name

Anthony J Kirk Dpm Pc

NPI Number

1578872438

NPI Type

Organization

Enumeration Date

09/27/2010

Specialties

(Taxonomies)

Code

261QP1100X

Primary Taxonomy

Yes

Licenses

State

Michigan

License Number

AK400050

Contact
Information

Purpose

Mailing
Location

Address

2050 BRETON RD SE
2050 BRETON RD SE

City

Grand Rapids
Grand Rapids

State

MI
MI

Postal Code

49546-5547
49546-5547

Country

US
US

Telephone Number

(616) 949-1524
(616) 949-1524

Authorized Official

Name

Ms. Pat Gillman

Title or Position

OFFICE MANAGER

Telephone Number

(616) 949-1524

Identifiers

Identifier

4854111170
4355335

Identifier State

Unknown
MI

Identifier Issuer

BCBS
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 09/27/2010

Provider Address