Provider Demographics
NPI:1669735759
Name:KURT EHLERT, MD, P.A.
Entity type:Organization
Organization Name:KURT EHLERT, MD, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KURT
Authorized Official - Middle Name:
Authorized Official - Last Name:EHLERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:866-885-5522
Mailing Address - Street 1:PO BOX 602752
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2752
Mailing Address - Country:US
Mailing Address - Phone:479-709-7280
Mailing Address - Fax:479-709-7281
Practice Address - Street 1:1500 DODSON AVE
Practice Address - Street 2:SUITE 285
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72901-5182
Practice Address - Country:US
Practice Address - Phone:479-709-7280
Practice Address - Fax:479-709-7281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty