Provider Demographics
NPI:1508907445
Name:KIRGIS, LORI M (DC)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:M
Last Name:KIRGIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 E GREENBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46725-8622
Mailing Address - Country:US
Mailing Address - Phone:260-248-2194
Mailing Address - Fax:
Practice Address - Street 1:695 N OPPORTUNITY DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA CITY
Practice Address - State:IN
Practice Address - Zip Code:46725-1041
Practice Address - Country:US
Practice Address - Phone:260-244-3665
Practice Address - Fax:260-248-4496
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001923A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00152264OtherPALMETTO GBA M
IN7676280OtherAETNA
IN0000000334173OtherUNICARE HEALTHCARE PLANS
IN2737868OtherALLIED BENEFITS
IN200478390AOtherMANAGED HEALTH SERVICE IN
IN200325660OtherMANAGED HEALTH SERVICE IN
IN000000334173OtherIN BLUE SHIELD ANTHEM
IN200325660Medicaid
IN214620OtherUNICARE PFFS CLAIMS DEPT
IN214620AOtherHUMANA CLAIMS
IN200325660OtherHARMONY HEALTH PLAN
IN214620AOtherMEDICARE COMPLETE ESSENTI
IN214620AOtherSECURE HORIZONS DIRECT
IN214620AMedicare ID - Type Unspecified
IN200325660OtherHARMONY HEALTH PLAN