Provider Demographics
NPI:1073539029
Name:CURTIS, BRUCE TODD (MD)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:TODD
Last Name:CURTIS
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 1:1920 E BASELINE RD
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1511
Mailing Address - Country:US
Mailing Address - Phone:480-345-5000
Mailing Address - Fax:
Practice Address - Street 1:1920 E BASELINE RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1511
Practice Address - Country:US
Practice Address - Phone:480-345-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ231362085R0202X
KY304442085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100043570Medicaid
KY000000545149OtherBCBS
KY7100043570Medicaid
KY000000545149OtherBCBS
KY00280043Medicare PIN