Provider Demographics
NPI:1891882213
Name:MENTZER, KURT D (MD)
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:D
Last Name:MENTZER
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 1:2741 DEBARR RD STE C408
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2980
Mailing Address - Country:US
Mailing Address - Phone:076-467-8469
Mailing Address - Fax:
Practice Address - Street 1:2741 DEBARR RD STE C408
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2980
Practice Address - Country:US
Practice Address - Phone:076-467-8469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK6265207XS0106X
MDD62258207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD3017Medicaid
AK6265OtherSTATE LICENSE