Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 232526-1 | NY |
Y | 207SG0201X | Clinical Genetics (M.D.) | 23460 | MS |
NPI | 1740400506 |
---|---|
Provider Name | Dr. Brian M Kirmse |
First Address | Jackson, MS 39216-4500 |
Second Address | Jackson, MS 39216-4500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 05/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02597400 | (05) | NY |
02678344 | (05) | MS |
I20760 | (02) | NY |