MEDICARE: DR. MICHAEL STEPHEN KIRK JR. D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	38MC00578200	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	001745107	OTHER	NJ	HIGHMARK BLUESHIELD GROUP
2	7272582	OTHER	NJ	AETNA PPO
3	001639659	OTHER	NJ	HIGHMARK BLUESHIELD PROVI
4	2410673000	OTHER	NJ	AMERIHEALTH HMO GROUP
5	3557463	OTHER	NJ	AETNA HMO
6	2314204000	OTHER	NJ	AMERIHEALTH HMO PROVIDER

General Provider Information

NPI Number	:	1922112549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL STEPHEN KIRK JR. D.C.

Provider Business Mailing Address
First Line	:	208 CREEK CROSSING BLVD
Second Line	:
City	:	HAINESPORT
State	:	NJ
Zip	:	08036-2766
Country	:	US
Telephone Number	:	856-727-8300
Fax Number	:	609-667-7263

Provider Business Practice Location Address
First Line	:	208 CREEK CROSSING BLVD
Second Line	:
City	:	HAINESPORT
State	:	NJ
Zip	:	08036-2766
Country	:	US
Telephone Number	:	856-727-8300
Fax Number	:	856-727-8346

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	12/29/2017

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Directions to “ DR. MICHAEL STEPHEN KIRK JR. D.C.” Practice Location

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