Provider Demographics
NPI:1619089646
Name:LAMERS, KURT B (PA)
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:B
Last Name:LAMERS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1010 4TH ST SW
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-2857
Mailing Address - Country:US
Mailing Address - Phone:641-422-7847
Mailing Address - Fax:641-422-7999
Practice Address - Street 1:1010 4TH ST SW
Practice Address - Street 2:SUITE 105
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-2857
Practice Address - Country:US
Practice Address - Phone:641-422-7847
Practice Address - Fax:641-422-7999
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA000796363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA42711OtherWELLMARK
IAI11633Medicare ID - Type Unspecified
IA42711OtherWELLMARK