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General NPI Number Information
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NPI Number | 1063547164
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Entity Type | Organization
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Legal Business Name | KIRT BIERIG D O INC
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 03/23/2015
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Provider Practice Location Address
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Address Line | 410 4TH ST SUITE A
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City | ALVA
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State | OK
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Zip | 73717-2372
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Country | US
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Telephone | 580-327-7842
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 952
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City | ALVA
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State | OK
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Zip | 73717-0952
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Country | US
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Telephone | 580-327-7842
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CYNTHIA M BIERIG
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Credential | R.N.
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Telephone | 580-327-7842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2013
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License Number State | OK
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