Provider Demographics
NPI:1326079708
Name:KURTZ, JENIFER A (MD)
Entity Type:Individual
Prefix:DR
First Name:JENIFER
Middle Name:A
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:PO BOX 391
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37901-0391
Mailing Address - Country:US
Mailing Address - Phone:865-573-4794
Mailing Address - Fax:865-573-4794
Practice Address - Street 1:3608 BLUFF POINT DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-2806
Practice Address - Country:US
Practice Address - Phone:865-573-4794
Practice Address - Fax:865-573-4794
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD31607207RG0300X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3841490Medicaid
TNH07918Medicare UPIN
TN3841499Medicare ID - Type Unspecified