Provider Demographics
NPI:1922106004
Name:QUIRK, JAMES H JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:QUIRK
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 116538
Mailing Address - Street 2:CPG NORTH RESERVE WALKIN
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368
Mailing Address - Country:US
Mailing Address - Phone:406-721-0533
Mailing Address - Fax:406-728-4463
Practice Address - Street 1:2230 NORTH RESERVE ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808
Practice Address - Country:US
Practice Address - Phone:406-721-0533
Practice Address - Fax:406-728-4463
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2015-06-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MT10408207Q00000X
WY7608A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTH41151Medicare UPIN