Provider Demographics
NPI:1174580187
Name:HIRT, THOMAS W (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:W
Last Name:HIRT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:25 MERCHANT STREET
Mailing Address - Street 2:SUITE 220
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-3740
Mailing Address - Country:US
Mailing Address - Phone:513-533-6507
Mailing Address - Fax:513-645-9767
Practice Address - Street 1:6551 CENTERVILLE BUSINESS PKWY STE 100
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-2696
Practice Address - Country:US
Practice Address - Phone:937-291-6830
Practice Address - Fax:937-291-6893
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2020-07-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35-08-3620-H207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2475496Medicaid
OHI07994Medicare UPIN
OH2475496Medicaid
HI4134861Medicare PIN