Provider Demographics
NPI:1669613667
Name:KURT V GOLD M.D. P.C.
Entity type:Organization
Organization Name:KURT V GOLD M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:VAN
Authorized Official - Last Name:GOLD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-933-2016
Mailing Address - Street 1:7919 WAKELEY PLZ
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3677
Mailing Address - Country:US
Mailing Address - Phone:402-933-2016
Mailing Address - Fax:402-393-8369
Practice Address - Street 1:7919 WAKELEY PLZ
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3677
Practice Address - Country:US
Practice Address - Phone:402-933-2016
Practice Address - Fax:402-393-8369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-20
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE194632081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA40834OtherMEDICARE ID
IA1158105Medicaid
273621GOOtherMEDICARE ID
IA40834OtherMEDICARE ID