| Kirk Agerson Md Pc | |
|
2849 Michigan St Ne Grand Rapids MI 49506-1216 | |
| (616) 285-6450 | |
| (616) 285-6455 |
| Full Name | Kirk Agerson Md Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2849 Michigan St Ne, Grand Rapids, Michigan |
| Authorized Official Name and Position | Kirk Joseph Agerson (PRESIDENT) |
| Authorized Official Contact | 6165400876 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kirk Agerson Md Pc 2849 Michigan St Ne Grand Rapids MI 49506-1216 Ph: (616) 285-6450 | Kirk Agerson Md Pc 2849 Michigan St Ne Grand Rapids MI 49506-1216 Ph: (616) 285-6450 |
| NPI Number | 1275001034 |
|---|---|
| Provider Enumeration Date | 11/08/2018 |
| Last Update Date | 11/08/2018 |
| Medicare PECOS PAC ID | 2466792593 |
|---|---|
| Medicare Enrollment ID | O20190327000892 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275001034 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Kirk J Agerson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245226380 PECOS PAC ID: 3173718525 Enrollment ID: I20101110001254 |
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