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NPI Code Detail

MEDICARE: KEVIN S HIRSCH MD

MEDICARE: KEVIN S HIRSCH MD
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
12085R0202XDiagnostic Radiology Physician33259AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1886913OTHERAZAHCCCS
284772OTHERAZURL

General Provider Information

NPI Number : 1891784849
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN S HIRSCH MD
Provider Business Mailing Address
First Line : 1111 E MCDOWELL RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85006-2612
Country : US
Telephone Number : 602-239-4601
Fax Number : 602-239-3075
Provider Business Practice Location Address
First Line : 1111 E MCDOWELL RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85006-2612
Country : US
Telephone Number : 602-239-4601
Fax Number : 602-239-3075
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2005
Last Update Date : 01/09/2012

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