Provider Demographics
NPI:1720099567
Name:KURTZ, BRUCE R (MD)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:R
Last Name:KURTZ
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 1:1025 MARSH ST
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-4752
Mailing Address - Country:US
Mailing Address - Phone:507-625-4031
Mailing Address - Fax:
Practice Address - Street 1:1025 MARSH ST
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-4752
Practice Address - Country:US
Practice Address - Phone:507-345-2623
Practice Address - Fax:507-389-4685
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN35282207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HP42442OtherHEALTH PARTNERS
115402OtherUCARE
MN1M517KUOtherBLUE CROSS BLUE SHIELD
200871OtherMEDICA
967551016036OtherPREFERRED ONE
115402OtherUCARE