Provider Demographics
NPI:1801927108
Name:ROHREN, KURT W (MD)
Entity type:Individual
Prefix:
First Name:KURT
Middle Name:W
Last Name:ROHREN
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:PO BOX 394
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:NE
Mailing Address - Zip Code:68028-0394
Mailing Address - Country:US
Mailing Address - Phone:877-406-2916
Mailing Address - Fax:
Practice Address - Street 1:1010 THREE SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-8296
Practice Address - Country:US
Practice Address - Phone:970-764-2286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO314572085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CORAB6508OtherBLUE CROSS BLUE SHIELD
UTT0845Medicaid
CO01314574Medicaid
66551OtherPRESBYTERIAN HEALTH
CO841155936001OtherROCKY MOUNTAIN HEALTH
WA8378317Medicaid
WY114630100Medicaid
84115593602OtherPACIFICARE
NMW4726Medicaid
CAXPY191623Medicaid
AZ194994Medicaid
ALMD457COMedicaid
TXP8B114117Medicaid
CO841155936001OtherROCKY MOUNTAIN HEALTH
UTT0845Medicaid
WA8378317Medicaid