Provider Demographics
NPI:1780715482
Name:KURTH, KARL WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:KARL
Middle Name:WILLIAM
Last Name:KURTH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:GA
Mailing Address - Zip Code:30143-1503
Mailing Address - Country:US
Mailing Address - Phone:706-692-4243
Mailing Address - Fax:706-253-4243
Practice Address - Street 1:95 N MAIN ST
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:GA
Practice Address - Zip Code:30143-1503
Practice Address - Country:US
Practice Address - Phone:706-692-4243
Practice Address - Fax:706-253-4243
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5913111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor