Dimitris, Kirk D

Dimitris, Kirk D is an individual health care provider with primary practice located at 1160 Kepler Dr , Green Bay WI 54311-8321. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Dimitris, Kirk D can be contacted via phone (920) 288-5555.

Contact Information

Primary practice address
1160 Kepler Dr Green Bay WI 54311-8321
Phone: (920) 288-5555
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 52604-020 Wisconsin
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X ME100953 Florida
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 35.085490 Ohio

Profile Details

NPI number 1518020429
LBN Legal business name Dimitris, Kirk D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2006
Last updated Apr 11th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518020429 NPPES
Wisconsin Other 390806395003 CHAMPUS
Wisconsin Other 1518020429 CHAMPUS
Wisconsin MEDICAID 207X00000X CHAMPUS

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