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General NPI Number Information
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NPI Number | 1578628467
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Entity Type | Individual
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Provider Name | ANTHONY DOUGLAS HIRTZ MD
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Gender | Male
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 05/31/2011
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Provider Practice Location Address
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Address Line | 900 WASHINGTON RD CREDENTIAL'S OFFICE, KELLER ARMY COMMUNITY HOSPITAL
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City | WEST POINT
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State | NY
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Zip | 10996-1109
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Country | US
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Telephone | 845-938-4114
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Fax |
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Provider Business Mailing Address
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Address Line | 900 WASHINGTON RD CREDENTIAL'S OFFICE, KELLER ARMY COMMUNITY HOSPITAL
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City | WEST POINT
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State | NY
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Zip | 10996-1109
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Country | US
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Telephone | 845-938-4114
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101053288
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License Number State | VA
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