Provider Demographics
NPI:1376797985
Name:KIRSCH, PETER T (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:T
Last Name:KIRSCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8003 VINE CREST AVE
Mailing Address - Street 2:UNIT 12
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-4695
Mailing Address - Country:US
Mailing Address - Phone:502-741-5354
Mailing Address - Fax:502-223-9829
Practice Address - Street 1:8003 VINE CREST AVE
Practice Address - Street 2:UNIT 12
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-4695
Practice Address - Country:US
Practice Address - Phone:502-741-5354
Practice Address - Fax:502-223-9829
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY16539207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery