Basic Information
| Provider Information | |||||||||
| NPI: | 1407847452 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HIRSCH | ||||||||
| FirstName: | MARC | ||||||||
| MiddleName: | F | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 990 WILKINSON TRCE | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | BOWLING GREEN | ||||||||
| State: | KY | ||||||||
| PostalCode: | 421033404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707814043 | ||||||||
| FaxNumber: | 2707814196 | ||||||||
| Practice Location | |||||||||
| Address1: | 990 WILKINSON TRCE | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | BOWLING GREEN | ||||||||
| State: | KY | ||||||||
| PostalCode: | 421033404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707814043 | ||||||||
| FaxNumber: | 2707814196 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/31/2005 | ||||||||
| LastUpdateDate: | 01/09/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 41519 | KY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.