Provider Demographics
NPI:1225098916
Name:MCKIRGAN, CRAIG C (DO)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:C
Last Name:MCKIRGAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 IRMC DR
Mailing Address - Street 2:SUITE 160
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3674
Mailing Address - Country:US
Mailing Address - Phone:724-465-2676
Mailing Address - Fax:724-349-1830
Practice Address - Street 1:120 IRMC DR
Practice Address - Street 2:SUITE 160
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3674
Practice Address - Country:US
Practice Address - Phone:724-465-2676
Practice Address - Fax:724-349-1830
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS008464L207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014692800001Medicaid
PA055947GMDMedicare PIN
PA0014692800001Medicaid
PA188868Medicare PIN