Provider Demographics
NPI:1164473997
Name:HECOX, KURT E (MD)
Entity Type:Individual
Prefix:DR
First Name:KURT
Middle Name:E
Last Name:HECOX
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9000 W WISCONSIN AVE
Mailing Address - Street 2:PEDIATRIC NEUROLOGY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-266-3464
Mailing Address - Fax:414-266-3466
Practice Address - Street 1:9000 W WISCONSIN AVE
Practice Address - Street 2:PEDIATRIC NEUROLOGY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4874
Practice Address - Country:US
Practice Address - Phone:414-266-3464
Practice Address - Fax:414-266-3466
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI228602084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1164473997Medicaid
WIK400097679Medicare PIN
WI1164473997Medicaid
B53498Medicare UPIN