Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | AT0443 | MS |
Y | 213ES0000X | Sports Medicine | AT0443 | MS |
NPI | 1518271634 |
---|---|
Provider Name | Kirk Emick |
First Address | University, MS 38677-9985 |
Second Address | University, MS 38677-9985 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2010 |
Last Update Date | 30/07/2010 |