Basic Information
| Provider Information | |||||||||
| NPI: | 1720366628 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KIRK SAHAGIAN DO PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 787 WEATHERLY DR | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | CLARKSVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370438949 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9315520380 | ||||||||
| FaxNumber: | 9315513157 | ||||||||
| Practice Location | |||||||||
| Address1: | 787 WEATHERLY DR | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | CLARKSVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370438949 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9315520380 | ||||||||
| FaxNumber: | 9315513157 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2011 | ||||||||
| LastUpdateDate: | 07/26/2011 | ||||||||
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| AuthorizedOfficialLastName: | SAHAGIAN | ||||||||
| AuthorizedOfficialFirstName: | KIRK | ||||||||
| AuthorizedOfficialMiddleName: | GREGORY | ||||||||
| AuthorizedOfficialTitleorPosition: | SOLE MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 9315520380 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.