Provider Demographics
NPI:1467550483
Name:SOWERS, KURT (MD)
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:
Last Name:SOWERS
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 1:350 BMH PHYSICIANS OFFICE BLDG
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37804-5819
Mailing Address - Country:US
Mailing Address - Phone:865-982-5044
Mailing Address - Fax:888-468-8096
Practice Address - Street 1:200 MEDICAL CENTER DR STE 1P
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-9477
Practice Address - Country:US
Practice Address - Phone:606-487-7991
Practice Address - Fax:606-439-6685
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD056926207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ038148Medicaid
NV1467550483Medicaid