Provider Demographics
NPI:1487795399
Name:KIRGIS, JAMIE L (DC)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:L
Last Name:KIRGIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 E GREENBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46725-8622
Mailing Address - Country:US
Mailing Address - Phone:260-248-2194
Mailing Address - Fax:
Practice Address - Street 1:695 N OPPORTUNITY DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA CITY
Practice Address - State:IN
Practice Address - Zip Code:46725-1041
Practice Address - Country:US
Practice Address - Phone:260-244-3665
Practice Address - Fax:260-248-4496
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001982A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00152266OtherPALMETTO GBA M
IN200432250Medicaid
IN2919344OtherALLIED BENEFITS
IN7437258OtherAETNA
INP00152266OtherRR MEDICARE
IN000000336368OtherIN BLUE SHIELD ANTHEM
IN214620BOtherAPWU HEALTH PLAN
IN214620BOtherHUMANA CLAIMS
IN214620BOtherMEDICARE COMPLETE ESSNTL
IN200432250OtherMANAGED HEALTH SERVICE IN
IN214620BOtherSECURE HORIZONS DIRECT
IN214620BOtherUNICARE PFFS
IN200432250OtherMANAGED HEALTH SERVICE IN
IN200432250Medicaid