Provider Demographics
NPI:1033437694
Name:KURT A BREWSTER MD PC
Entity Type:Organization
Organization Name:KURT A BREWSTER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:A
Authorized Official - Last Name:BREWSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-474-1020
Mailing Address - Street 1:1601 NE 6TH STREET
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-1494
Mailing Address - Country:US
Mailing Address - Phone:541-474-1020
Mailing Address - Fax:541-474-1108
Practice Address - Street 1:1601 NE 6TH STREET
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-1494
Practice Address - Country:US
Practice Address - Phone:541-474-1020
Practice Address - Fax:541-474-1108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-06
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD20661207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty