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NPI Code Detail

MEDICARE: PROF. BARRY MICHAEL QUIRK JR. DPT

MEDICARE: PROF. BARRY MICHAEL QUIRK JR. DPT
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
1225100000XPhysical Therapist07085LA
2225100000XPhysical TherapistPT5187MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21598959306OTHERMSNPI

General Provider Information

NPI Number : 1598959306
Entity Type Code : Individual
Provider Name (Legal Business Name) : PROF. BARRY MICHAEL QUIRK JR. DPT
Provider Business Mailing Address
First Line : PO BOX 8419
Second Line :
City : BILOXI
State : MS
Zip : 39535-8087
Country : US
Telephone Number : 228-388-5714
Fax Number : 228-388-0017
Provider Business Practice Location Address
First Line : 1800 BEACH DR
Second Line :
City : GULFPORT
State : MS
Zip : 39507-1553
Country : US
Telephone Number : 228-897-4452
Fax Number : 228-897-4481
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2007
Last Update Date : 01/08/2013

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