Provider Demographics
NPI:1194019679
Name:KURTZ, JOAN HELENE (MD)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:HELENE
Last Name:KURTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16136 W. INDIANOLA AVE.
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-8029
Mailing Address - Country:US
Mailing Address - Phone:623-266-0388
Mailing Address - Fax:623-256-6328
Practice Address - Street 1:16136 W. INDIANOLA AVE.
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-8029
Practice Address - Country:US
Practice Address - Phone:623-266-0388
Practice Address - Fax:623-256-6328
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10492208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics