Provider Demographics
NPI:1720366628
Name:KIRK SAHAGIAN DO PLLC
Entity Type:Organization
Organization Name:KIRK SAHAGIAN DO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:SAHAGIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:931-552-0380
Mailing Address - Street 1:787 WEATHERLY DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-8949
Mailing Address - Country:US
Mailing Address - Phone:931-552-0380
Mailing Address - Fax:931-551-3157
Practice Address - Street 1:787 WEATHERLY DR
Practice Address - Street 2:SUITE 400
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-8949
Practice Address - Country:US
Practice Address - Phone:931-552-0380
Practice Address - Fax:931-551-3157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty