Provider Demographics
NPI:1780023655
Name:AMMERMAN, KURT DANIEL (DO)
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:DANIEL
Last Name:AMMERMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 ALICK MCBEAN RD
Mailing Address - Street 2:
Mailing Address - City:KINSEY
Mailing Address - State:MT
Mailing Address - Zip Code:59338-9004
Mailing Address - Country:US
Mailing Address - Phone:406-233-2600
Mailing Address - Fax:
Practice Address - Street 1:2600 WILSON ST
Practice Address - Street 2:
Practice Address - City:MILES CITY
Practice Address - State:MT
Practice Address - Zip Code:59301-5094
Practice Address - Country:US
Practice Address - Phone:406-233-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT66930208600000X
MI5315059323390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program