Provider Demographics
NPI:1679514491
Name:FRANTZ, KURT SMITH (MD)
Entity Type:Individual
Prefix:DR
First Name:KURT
Middle Name:SMITH
Last Name:FRANTZ
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 58
Mailing Address - Street 2:
Mailing Address - City:YELLOWSTONE NATIONAL PARK
Mailing Address - State:WY
Mailing Address - Zip Code:82190-0058
Mailing Address - Country:US
Mailing Address - Phone:307-344-7965
Mailing Address - Fax:307-344-7336
Practice Address - Street 1:1 UPPER MAMMOTH
Practice Address - Street 2:MAMMOTH CLINIC
Practice Address - City:YELLOWSTONE NATIONAL PARK
Practice Address - State:WY
Practice Address - Zip Code:82190-0058
Practice Address - Country:US
Practice Address - Phone:307-344-7965
Practice Address - Fax:307-344-7336
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY7023A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0141168Medicaid
MT0141168Medicaid
C94944Medicare ID - Type Unspecified