Provider Demographics
NPI:1376520056
Name:KURTZ, BRADLEY DAVID (DO)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:DAVID
Last Name:KURTZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5657 S HIMALAYA ST
Mailing Address - Street 2:SUITE100
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-5307
Mailing Address - Country:US
Mailing Address - Phone:303-699-6200
Mailing Address - Fax:720-870-0242
Practice Address - Street 1:2373 CENTRAL PARK BLVD UNIT 202
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238-2300
Practice Address - Country:US
Practice Address - Phone:303-699-6200
Practice Address - Fax:720-974-9811
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42432208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO21332843Medicaid
I10390Medicare UPIN
CO21332843Medicaid