Provider Demographics
NPI:1992989651
Name:WILLIAM J. KIRMES D.O.,PA.
Entity type:Organization
Organization Name:WILLIAM J. KIRMES D.O.,PA.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:KIRMES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:603-623-6757
Mailing Address - Street 1:35 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-6116
Mailing Address - Country:US
Mailing Address - Phone:603-623-6757
Mailing Address - Fax:
Practice Address - Street 1:35 HIGH ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-6116
Practice Address - Country:US
Practice Address - Phone:603-623-6757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-18
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH6046204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHD93375Medicare UPIN