Provider Demographics
NPI:1619069051
Name:KURUCZ, MARCUS A (MD)
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:A
Last Name:KURUCZ
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 760
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47501-0760
Mailing Address - Country:US
Mailing Address - Phone:812-825-4173
Mailing Address - Fax:812-257-8062
Practice Address - Street 1:1401 MEMORIAL AVE STE C
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IN
Practice Address - Zip Code:47501-3154
Practice Address - Country:US
Practice Address - Phone:812-254-8856
Practice Address - Fax:812-254-4831
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01062746A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200838210Medicaid
IN000000494967OtherBCBS
INP00758258OtherMEDICARE RAILROAD
IN188270CMedicare PIN