Provider Demographics
NPI:1073664207
Name:KURT W. KANTZLER D.O., INC.
Entity Type:Organization
Organization Name:KURT W. KANTZLER D.O., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KURT
Authorized Official - Middle Name:
Authorized Official - Last Name:KANTZLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:256-543-2867
Mailing Address - Street 1:215 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-4217
Mailing Address - Country:US
Mailing Address - Phone:256-543-2867
Mailing Address - Fax:256-546-7354
Practice Address - Street 1:215 S 5TH ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-4217
Practice Address - Country:US
Practice Address - Phone:256-543-2867
Practice Address - Fax:256-546-7354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO637207KA0200X, 207YX0007X
AL207Q00000X
ALMD27282207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALI349Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER