Provider Demographics
NPI:1861445348
Name:GARMAGER, KIRK KENDAL (MD)
Entity Type:Individual
Prefix:DR
First Name:KIRK
Middle Name:KENDAL
Last Name:GARMAGER
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 1:2771 OAKDALE BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-9747
Mailing Address - Country:US
Mailing Address - Phone:319-545-7310
Mailing Address - Fax:319-626-7314
Practice Address - Street 1:2769 HEARTLAND DR
Practice Address - Street 2:SUITE 105
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2732
Practice Address - Country:US
Practice Address - Phone:319-545-7310
Practice Address - Fax:319-545-7314
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA304072085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2121962Medicaid
IA38535OtherBLUE CROSS BLUE SHIELD
IA3121962Medicaid
IA1121962Medicaid
IA38533OtherBLUE CROSS BLUE SHIELD
IA19352OtherBLUE CROSS BLUE SHIELD
IA38534OtherBLUE CROSS BLUE SHIELD
IAI14860Medicare PIN