Provider Demographics
NPI:1376522623
Name:KURTIS, JONATHAN R (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:R
Last Name:KURTIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4 WEST ST
Mailing Address - Street 2:
Mailing Address - City:WEST HATFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01088-9515
Mailing Address - Country:US
Mailing Address - Phone:413-586-8200
Mailing Address - Fax:413-582-1460
Practice Address - Street 1:4 WEST ST
Practice Address - Street 2:
Practice Address - City:WEST HATFIELD
Practice Address - State:MA
Practice Address - Zip Code:01088-9515
Practice Address - Country:US
Practice Address - Phone:413-586-8200
Practice Address - Fax:413-582-1460
Is Sole Proprietor?:No
Enumeration Date:2006-01-14
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA46653207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA04-2629461OtherNORTHEAST HEALTHCARE ALLI
MA772036OtherTUFTS
MA04-2629461OtherGREAT-WEST
MA1025270OtherCIGNA
MA04-2629461OtherNORTH AMERICAN PREFERRED
MA2192448OtherAETNA
MA04-2629461OtherCONSOLIDATED
MAG10007OtherBCBS MA
MA19721OtherHEALTH NEW ENGLAND
MA466531OtherCONNECTICARE
MA04-2629461OtherUNICARE/GIC
MA171631OtherHARVARD PILGRIM
MA9713921Medicaid
MA04-2629461OtherNORTHEAST HEALTH DIRECT
MA04-2629461OtherPLAN VISTA
MA04-2629461OtherPRIVATE HEALTHCARE SYSTEM
MA25830OtherBMC
MA2192448OtherAETNA
MA9713921Medicaid