Provider Demographics
NPI:1376586024
Name:DEARNBARGER, KURT M (MD)
Entity Type:Individual
Prefix:DR
First Name:KURT
Middle Name:M
Last Name:DEARNBARGER
Suffix:
Gender:M
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 320
Mailing Address - Street 2:
Mailing Address - City:LOVINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61937-0320
Mailing Address - Country:US
Mailing Address - Phone:217-873-5851
Mailing Address - Fax:217-873-1599
Practice Address - Street 1:222 SOUTH RAILROAD ST.
Practice Address - Street 2:
Practice Address - City:LOVINGTON
Practice Address - State:IL
Practice Address - Zip Code:61937-0320
Practice Address - Country:US
Practice Address - Phone:217-873-5851
Practice Address - Fax:217-873-1599
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL204800Medicare ID - Type Unspecified
ILG42360Medicare UPIN