Provider Demographics
NPI:1740357177
Name:PIRTLE, JEFFREY SCOTT (PA-C)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:SCOTT
Last Name:PIRTLE
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:15465 FARMBROOK ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-1930
Mailing Address - Country:US
Mailing Address - Phone:586-292-1646
Mailing Address - Fax:
Practice Address - Street 1:24230 KARIM BLVD STE 100
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-2960
Practice Address - Country:US
Practice Address - Phone:248-745-4900
Practice Address - Fax:248-994-8005
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2024-08-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5601004417363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant