Provider Demographics
NPI:1568733624
Name:SIRKIN, JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:SIRKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 PECTEN CT
Mailing Address - Street 2:
Mailing Address - City:SANIBEL
Mailing Address - State:FL
Mailing Address - Zip Code:33957-4812
Mailing Address - Country:US
Mailing Address - Phone:239-472-2810
Mailing Address - Fax:239-472-2810
Practice Address - Street 1:8059 PADDINGTON LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45249-1542
Practice Address - Country:US
Practice Address - Phone:513-489-3303
Practice Address - Fax:513-489-3303
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-21
Last Update Date:2012-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 . 026027174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist