Provider Demographics
NPI:1497944326
Name:HIRT FOOT AND ANKLE SPECIALISTS P.C.
Entity Type:Organization
Organization Name:HIRT FOOT AND ANKLE SPECIALISTS P.C.
Other - Org Name:FENTON FOOT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:HIRT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:810-629-3338
Mailing Address - Street 1:14229 TORREY RD
Mailing Address - Street 2:STE 1
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-2640
Mailing Address - Country:US
Mailing Address - Phone:810-629-3338
Mailing Address - Fax:810-629-9243
Practice Address - Street 1:14229 TORREY RD
Practice Address - Street 2:STE 1
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-3308
Practice Address - Country:US
Practice Address - Phone:810-629-3338
Practice Address - Fax:810-629-9243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002200213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1497944326Medicaid
MI1497944326Medicaid
MI6090250001Medicare NSC