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General NPI Number Information
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NPI Number | 1912294174
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Entity Type | Organization
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Legal Business Name | PATRICIA A. KIRK DPM, PLLC
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Dates
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Enumeration Date | 07/07/2011
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Last Update Date | 07/07/2011
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Provider Practice Location Address
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Address Line | 16682 N WEST POINT PKWY APT. 281
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City | SURPRISE
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State | AZ
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Zip | 85374-4033
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Country | US
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Telephone | 623-229-8965
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Fax |
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Provider Business Mailing Address
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Address Line | 16682 N WEST POINT PKWY APT. 281
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City | SURPRISE
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State | AZ
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Zip | 85374-4033
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Country | US
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Telephone | 623-229-8965
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. PATRICIA A. KIRK
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Credential | DPM
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Telephone | 623-229-8965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 0717
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License Number State | AZ
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