MEDICARE: DR. ALLEN SCOTT KIRK DPM

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	213E00000X	Podiatrist	MD01471	NJ

Other Identifiers

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

General Provider Information

NPI Number	:	1619078227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLEN SCOTT KIRK DPM

Provider Business Mailing Address
First Line	:	1485C UNION VALLEY RD
Second Line	:
City	:	WEST MILFORD
State	:	NJ
Zip	:	07480
Country	:	US
Telephone Number	:	973-728-2211
Fax Number	:	973-728-2237

Provider Business Practice Location Address
First Line	:	1485 UNION VALLEY RD STE C
Second Line	:
City	:	WEST MILFORD
State	:	NJ
Zip	:	07480-1317
Country	:	US
Telephone Number	:	973-728-2211
Fax Number	:	973-728-2237

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

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	10/21/2008

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